Provider Demographics
NPI:1497392054
Name:KIRBY, KAREN JANE (LCSW,LCADC)
Entity type:Individual
Prefix:
First Name:KAREN
Middle Name:JANE
Last Name:KIRBY
Suffix:
Gender:F
Credentials:LCSW,LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:106 TAVISTOCK
Mailing Address - Street 2:
Mailing Address - City:CHERRY HILL
Mailing Address - State:NJ
Mailing Address - Zip Code:08034-4001
Mailing Address - Country:US
Mailing Address - Phone:856-883-0661
Mailing Address - Fax:
Practice Address - Street 1:104 N KING ST
Practice Address - Street 2:
Practice Address - City:GLOUCESTER CITY
Practice Address - State:NJ
Practice Address - Zip Code:08030-1417
Practice Address - Country:US
Practice Address - Phone:856-742-0900
Practice Address - Fax:856-742-0811
Is Sole Proprietor?:No
Enumeration Date:2019-12-03
Last Update Date:2021-02-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC058988001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical