Provider Demographics
NPI:1326062399
Name:BIEBERLE, KELLEY DAWN (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:KELLEY
Middle Name:DAWN
Last Name:BIEBERLE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:510 W SOUTH ST
Mailing Address - Street 2:
Mailing Address - City:SALINA
Mailing Address - State:KS
Mailing Address - Zip Code:67401-4046
Mailing Address - Country:US
Mailing Address - Phone:785-820-7427
Mailing Address - Fax:
Practice Address - Street 1:200 S SANTA FE AVE
Practice Address - Street 2:SUITE # 3
Practice Address - City:SALINA
Practice Address - State:KS
Practice Address - Zip Code:67401-3963
Practice Address - Country:US
Practice Address - Phone:785-823-7400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2006-07-26
Last Update Date:2011-07-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS6243104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker