Provider Demographics
NPI:1588681423
Name:GILBERTSON, KRISTINA (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:KRISTINA
Middle Name:
Last Name:GILBERTSON
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 1:400 MONTGOMERY ST
Mailing Address - Street 2:
Mailing Address - City:LAUREL
Mailing Address - State:MD
Mailing Address - Zip Code:20707-4202
Mailing Address - Country:US
Mailing Address - Phone:301-776-2980
Mailing Address - Fax:301-776-2980
Practice Address - Street 1:6201 GREENBELT RD
Practice Address - Street 2:SUITE U-18
Practice Address - City:BERWYN HEIGHTS
Practice Address - State:MD
Practice Address - Zip Code:20740-2354
Practice Address - Country:US
Practice Address - Phone:301-345-1919
Practice Address - Fax:301-345-5779
Is Sole Proprietor?:No
Enumeration Date:2006-07-16
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD119271041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical