Healthcare Provider Details

I. General information

NPI: 1780256024
Provider Name (Legal Business Name): CAITLIN E. KOLBA LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/15/2021
Last Update Date: 09/23/2025
Certification Date: 09/23/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3235 DELONG AVE
BETHLEHEM PA
18020-2839
US

IV. Provider business mailing address

3235 DELONG AVE
BETHLEHEM PA
18020-2839
US

V. Phone/Fax

Practice location:
  • Phone: 484-519-1805
  • Fax:
Mailing address:
  • Phone: 484-519-1805
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberSW138275
License Number StatePA
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberCW024317
License Number StatePA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: