Healthcare Provider Details

I. General information

NPI: 1831645290
Provider Name (Legal Business Name): KATELYNN KOLB
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 08/26/2016
Last Update Date: 07/06/2026
Certification Date: 07/06/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1898 CALHOUN ST STE 6
COLUMBIA SC
29201-2650
US

IV. Provider business mailing address

225 MYLES CT
LEXINGTON SC
29072-7867
US

V. Phone/Fax

Practice location:
  • Phone: 803-814-4459
  • Fax:
Mailing address:
  • Phone: 803-414-4572
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number12333
License Number StateSC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: