Provider Demographics
NPI:1528218070
Name:KILBRIDE, MELISSA LIPPMAN (LCSW, LICSW, LCSW-C)
Entity Type:Individual
Prefix:
First Name:MELISSA
Middle Name:LIPPMAN
Last Name:KILBRIDE
Suffix:
Gender:F
Credentials:LCSW, LICSW, LCSW-C
Other - Prefix:
Other - First Name:MELISSA
Other - Middle Name:BETH
Other - Last Name:LIPPMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LSW, LCSW
Mailing Address - Street 1:1425 11TH ST NW
Mailing Address - Street 2:UNIT 204
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20001-3302
Mailing Address - Country:US
Mailing Address - Phone:773-263-0536
Mailing Address - Fax:
Practice Address - Street 1:64 NEW YORK AVE NE
Practice Address - Street 2:4TH FLOOR
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20002-3320
Practice Address - Country:US
Practice Address - Phone:773-263-0436
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-09-22
Last Update Date:2008-10-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500785771041C0700X
IL149.0123921041C0700X
MD143501041C0700X
VA09040068971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical