Healthcare Provider Details

I. General information

NPI: 1992639538
Provider Name (Legal Business Name): KALIN THERESA GORIUP LCSWA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 06/10/2026
Last Update Date: 06/10/2026
Certification Date: 06/09/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

728 SPRINGDALE DR
EXTON PA
19341-2941
US

IV. Provider business mailing address

424 WESTRIDGE CT
WILMINGTON NC
28411-8601
US

V. Phone/Fax

Practice location:
  • Phone: 484-459-4512
  • Fax:
Mailing address:
  • Phone: 910-546-1347
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberP023183
License Number StateNC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: