Provider Demographics
NPI:1720595614
Name:KOLODZIEJ, HELEN (LCSW)
Entity Type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:KOLODZIEJ
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 1:9495 KEILMAN ST STE 5
Mailing Address - Street 2:
Mailing Address - City:SAINT JOHN
Mailing Address - State:IN
Mailing Address - Zip Code:46373-9295
Mailing Address - Country:US
Mailing Address - Phone:219-627-4499
Mailing Address - Fax:219-558-0859
Practice Address - Street 1:9495 KEILMAN ST STE 5
Practice Address - Street 2:
Practice Address - City:SAINT JOHN
Practice Address - State:IN
Practice Address - Zip Code:46373-9295
Practice Address - Country:US
Practice Address - Phone:219-627-4499
Practice Address - Fax:219-558-0859
Is Sole Proprietor?:Yes
Enumeration Date:2018-01-02
Last Update Date:2018-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN34008017A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical