Healthcare Provider Details

I. General information

NPI: 1396017422
Provider Name (Legal Business Name): KATE KOLBERT M.A., LPC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 02/06/2012
Last Update Date: 02/06/2012
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

37 CANTERBURY LN
WESTFIELD NJ
07090-1935
US

IV. Provider business mailing address

37 CANTERBURY LN
WESTFIELD NJ
07090-1935
US

V. Phone/Fax

Practice location:
  • Phone: 908-654-6500
  • Fax: 908-654-6645
Mailing address:
  • Phone: 908-654-6500
  • Fax: 908-654-6645

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number37PC00011000
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: