Provider Demographics
NPI:1194552091
Name:NOLL, KARYN LEIGH (MALS, LMSW)
Entity type:Individual
Prefix:MRS
First Name:KARYN
Middle Name:LEIGH
Last Name:NOLL
Suffix:
Gender:F
Credentials:MALS, LMSW
Other - Prefix:MISS
Other - First Name:KARYN
Other - Middle Name:LEIGH
Other - Last Name:MOTIKA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:MALS, LMSW
Mailing Address - Street 1:817 NOBLE ST
Mailing Address - Street 2:
Mailing Address - City:KUTZTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:19530-9728
Mailing Address - Country:US
Mailing Address - Phone:484-538-9909
Mailing Address - Fax:
Practice Address - Street 1:22-24 N. FRANKLIN STREET
Practice Address - Street 2:
Practice Address - City:FLEETWOOD
Practice Address - State:PA
Practice Address - Zip Code:19522-1350
Practice Address - Country:US
Practice Address - Phone:610-944-0445
Practice Address - Fax:610-944-8834
Is Sole Proprietor?:No
Enumeration Date:2024-09-16
Last Update Date:2024-09-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW142078104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker