Provider Demographics
NPI:1164989562
Name:HOBSON, KIMBERLY (LCSW-C)
Entity Type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:
Last Name:HOBSON
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1040 WILLIAM ST
Mailing Address - Street 2:
Mailing Address - City:BALTIMORE
Mailing Address - State:MD
Mailing Address - Zip Code:21230-4190
Mailing Address - Country:US
Mailing Address - Phone:410-396-1207
Mailing Address - Fax:
Practice Address - Street 1:1040 WILLIAM ST
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21230-4190
Practice Address - Country:US
Practice Address - Phone:410-396-1207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-02-22
Last Update Date:2019-02-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD130871041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical