Provider Demographics
NPI:1437282225
Name:KOLB, ELIZABETH J (LCSW)
Entity Type:Individual
Prefix:
First Name:ELIZABETH
Middle Name:J
Last Name:KOLB
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:245 N BROADWAY STE 203
Mailing Address - Street 2:
Mailing Address - City:SLEEPY HOLLOW
Mailing Address - State:NY
Mailing Address - Zip Code:10591-2657
Mailing Address - Country:US
Mailing Address - Phone:917-754-1912
Mailing Address - Fax:914-332-7253
Practice Address - Street 1:245 N BROADWAY STE 203
Practice Address - Street 2:
Practice Address - City:SLEEPY HOLLOW
Practice Address - State:NY
Practice Address - Zip Code:10591
Practice Address - Country:US
Practice Address - Phone:917-754-1912
Practice Address - Fax:914-332-7253
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2019-05-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0727581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical