Provider Demographics
NPI:1932895851
Name:KRIETZ, KATLYN (LMSW)
Entity Type:Individual
Prefix:
First Name:KATLYN
Middle Name:
Last Name:KRIETZ
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 VIEW TRL
Mailing Address - Street 2:
Mailing Address - City:FAIRFIELD
Mailing Address - State:PA
Mailing Address - Zip Code:17320-8438
Mailing Address - Country:US
Mailing Address - Phone:717-408-5400
Mailing Address - Fax:
Practice Address - Street 1:417 E BALTIMORE ST
Practice Address - Street 2:
Practice Address - City:TANEYTOWN
Practice Address - State:MD
Practice Address - Zip Code:21787-2300
Practice Address - Country:US
Practice Address - Phone:301-791-3087
Practice Address - Fax:443-293-7086
Is Sole Proprietor?:No
Enumeration Date:2023-04-13
Last Update Date:2023-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD29736104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker