Healthcare Provider Details

I. General information

NPI: 1487562369
Provider Name (Legal Business Name): ABIGAIL KOLB PH.D., LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/31/2026
Last Update Date: 08/31/2026
Certification Date: 08/31/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1510 WELLSWOOD DR SE
ATLANTA GA
30315-4506
US

IV. Provider business mailing address

1510 WELLSWOOD DR SE
ATLANTA GA
30315-4506
US

V. Phone/Fax

Practice location:
  • Phone: 608-335-1900
  • Fax:
Mailing address:
  • Phone: 608-335-1900
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCSW010662
License Number StateGA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: