Provider Demographics
NPI:1801948609
Name:WEISBERG, KIMBERLY MAY (LCSW)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:MAY
Last Name:WEISBERG
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:537 RAVEN WAY
Mailing Address - Street 2:
Mailing Address - City:NAPLES
Mailing Address - State:FL
Mailing Address - Zip Code:34110-1167
Mailing Address - Country:US
Mailing Address - Phone:239-272-5066
Mailing Address - Fax:239-774-0801
Practice Address - Street 1:5867 WHITAKER RD
Practice Address - Street 2:
Practice Address - City:NAPLES
Practice Address - State:FL
Practice Address - Zip Code:34112-2963
Practice Address - Country:US
Practice Address - Phone:239-774-2904
Practice Address - Fax:239-774-1438
Is Sole Proprietor?:No
Enumeration Date:2007-01-18
Last Update Date:2015-08-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW83341041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical