Michele Kolb
Individual provider Active NPI Social Worker · Watertown, NY
NPI 1992316657 · NPPES record last updated Oct 15, 2021
Key facts
- NPI
- 1992316657
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Social Worker 104100000X
- License
- P112160 (NY)
- Practice address
- 211 J.B. Wise Plaza
Watertown, NY 13601 - Phone
- (315) 782-7445
- Fax
- (315) 779-1184
- NPI assigned
- Aug 14, 2020
- Sex
- Female
- Sole proprietor
- No
Organizations & group practices 2
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P112160 | NY | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Children'S Home of Jefferson County | Current |
Accepting new patients | |
| Children'S Home of Jefferson County | Current |
Accepting new patients |
Locations
211 Jb Wise Pl
Watertown, NY 13601
Phone (315) 788-7430
167 Polk St
Ste 300
Watertown, NY 13601
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Student in an Organized Health Care Education/Training Program | 390200000X | |||
| Social Worker | 104100000X | P112160 | NY | Yes |
Addresses
Primary practice location
211 J.B. Wise Plaza
Watertown, NY 13601
Mailing address
PO Box 6550
Watertown, NY 13601-6550
Phone (315) 788-7430
Other practice location 1
167 Polk St Ste 300
Watertown, NY 13601-2770
Phone (315) 782-7445
Other names
- Michele Haddad
Other providers in Watertown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Oct 15, 2021. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.