Provider Demographics
NPI:1215389283
Name:KOLBET, MARIA MADELEINE (SOCIAL WORKER)
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:MADELEINE
Last Name:KOLBET
Suffix:
Gender:F
Credentials:SOCIAL WORKER
Other - Prefix:
Other - First Name:MARIA
Other - Middle Name:MADELEINE
Other - Last Name:LOPEZ
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:3110 HAMILTON BLVD
Mailing Address - Street 2:
Mailing Address - City:ALLENTOWN
Mailing Address - State:PA
Mailing Address - Zip Code:18103-3630
Mailing Address - Country:US
Mailing Address - Phone:610-776-4304
Mailing Address - Fax:610-776-4309
Practice Address - Street 1:3110 HAMILTON BLVD
Practice Address - Street 2:
Practice Address - City:ALLENTOWN
Practice Address - State:PA
Practice Address - Zip Code:18103-3630
Practice Address - Country:US
Practice Address - Phone:610-776-4304
Practice Address - Fax:610-776-4309
Is Sole Proprietor?:No
Enumeration Date:2016-07-01
Last Update Date:2019-06-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL150.015823104100000X
IL149.0206591041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker