Healthcare Provider Details

I. General information

NPI: 1235692617
Provider Name (Legal Business Name): KAITLYN ELIZABETH SOLLENBERGER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 04/11/2019
Last Update Date: 09/01/2022
Certification Date: 09/01/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

903 S CHIQUES RD
MANHEIM PA
17545-9195
US

IV. Provider business mailing address

903 S CHIQUES RD
MANHEIM PA
17545-9195
US

V. Phone/Fax

Practice location:
  • Phone: 717-219-3314
  • Fax:
Mailing address:
  • Phone: 717-219-3314
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License NumberCW022848
License Number StatePA

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: