Provider Demographics
NPI:1700091014
Name:KIBRICK, LINDA M (MSW,LCSW,LMFT, LCADC)
Entity Type:Individual
Prefix:MS
First Name:LINDA
Middle Name:M
Last Name:KIBRICK
Suffix:
Gender:F
Credentials:MSW,LCSW,LMFT, LCADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 HEATHWOOD DR
Mailing Address - Street 2:
Mailing Address - City:EAST WINDSOR
Mailing Address - State:NJ
Mailing Address - Zip Code:08520-1820
Mailing Address - Country:US
Mailing Address - Phone:609-448-7333
Mailing Address - Fax:609-448-1359
Practice Address - Street 1:2 HEATHWOOD DR
Practice Address - Street 2:
Practice Address - City:EAST WINDSOR
Practice Address - State:NJ
Practice Address - Zip Code:08520-1820
Practice Address - Country:US
Practice Address - Phone:609-448-7333
Practice Address - Fax:609-448-1359
Is Sole Proprietor?:No
Enumeration Date:2007-05-11
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37LC00034500101YA0400X
NJ44SC001802001041C0700X
NJ37FI000109600106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Not Answered106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ645372Medicare ID - Type Unspecified
NJS32546Medicare UPIN