Provider Demographics
NPI:1124053020
Name:SOLKO, KATHRYN E (LISW)
Entity type:Individual
Prefix:
First Name:KATHRYN
Middle Name:E
Last Name:SOLKO
Suffix:
Gender:F
Credentials:LISW
Other - Prefix:
Other - First Name:KATHRYN
Other - Middle Name:EILEEN
Other - Last Name:SOLKO
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LISW
Mailing Address - Street 1:5406 MERLE HAY RD
Mailing Address - Street 2:P.O. BOX 707
Mailing Address - City:JOHNSTON
Mailing Address - State:IA
Mailing Address - Zip Code:50131-1209
Mailing Address - Country:US
Mailing Address - Phone:515-727-1535
Mailing Address - Fax:
Practice Address - Street 1:5406 MERLE HAY RD
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-1209
Practice Address - Country:US
Practice Address - Phone:515-727-1535
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-11
Last Update Date:2008-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA001451041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
IAP85038Medicare UPIN