Provider Demographics
NPI:1033938329
Name:KOSTIC, KATARINA (LSW)
Entity type:Individual
Prefix:
First Name:KATARINA
Middle Name:
Last Name:KOSTIC
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:25 W ELIZABETH LN
Mailing Address - Street 2:
Mailing Address - City:RICHBORO
Mailing Address - State:PA
Mailing Address - Zip Code:18954-1014
Mailing Address - Country:US
Mailing Address - Phone:267-574-2690
Mailing Address - Fax:
Practice Address - Street 1:2005 CITY LINE RD STE 300
Practice Address - Street 2:
Practice Address - City:BETHLEHEM
Practice Address - State:PA
Practice Address - Zip Code:18017-7701
Practice Address - Country:US
Practice Address - Phone:610-865-8177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-10-04
Last Update Date:2024-10-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW141694104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker