Provider Demographics
NPI:1598779217
Name:KULBISKI, JOSEPH VANCE (CLINICAL SOCIAL WORK)
Entity Type:Individual
Prefix:
First Name:JOSEPH
Middle Name:VANCE
Last Name:KULBISKI
Suffix:
Gender:M
Credentials:CLINICAL SOCIAL WORK
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:2500 MEADOWOOD DR
Mailing Address - Street 2:
Mailing Address - City:MANHATTAN
Mailing Address - State:KS
Mailing Address - Zip Code:66502-2029
Mailing Address - Country:US
Mailing Address - Phone:785-776-1711
Mailing Address - Fax:
Practice Address - Street 1:600 CAISSON HILL ROAD
Practice Address - Street 2:IRWIN ARMY COMMUNITY HOSPITAL
Practice Address - City:FORT RILEY
Practice Address - State:KS
Practice Address - Zip Code:66442-5037
Practice Address - Country:US
Practice Address - Phone:785-239-7155
Practice Address - Fax:785-239-7364
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-28
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLSCSW 20351041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical