Provider Demographics
NPI:1083703706
Name:LEMBO, KATHLEEN C (LCSW)
Entity Type:Individual
Prefix:MS
First Name:KATHLEEN
Middle Name:C
Last Name:LEMBO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:575 18TH AVE
Mailing Address - Street 2:
Mailing Address - City:VERO BEACH
Mailing Address - State:FL
Mailing Address - Zip Code:32962
Mailing Address - Country:US
Mailing Address - Phone:772-562-6096
Mailing Address - Fax:
Practice Address - Street 1:777 37TH STREET
Practice Address - Street 2:SUITE C101 NEW HORIZONS VERO BEACH OUTPATIENT
Practice Address - City:VERO BEACH
Practice Address - State:FL
Practice Address - Zip Code:32960
Practice Address - Country:US
Practice Address - Phone:772-778-7217
Practice Address - Fax:772-778-7220
Is Sole Proprietor?:No
Enumeration Date:2006-10-12
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW4618104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
FLE0157ZMedicare ID - Type Unspecified