Provider Demographics
NPI:1932588589
Name:NEBLETT, KATHLEEN (LCSW-C)
Entity Type:Individual
Prefix:MRS
First Name:KATHLEEN
Middle Name:
Last Name:NEBLETT
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 1:11660 BACHELORS HOPE COURT
Mailing Address - Street 2:
Mailing Address - City:ISSUE
Mailing Address - State:MD
Mailing Address - Zip Code:20645
Mailing Address - Country:US
Mailing Address - Phone:301-751-5119
Mailing Address - Fax:201-934-1291
Practice Address - Street 1:616 CHARLES ST
Practice Address - Street 2:
Practice Address - City:LA PLATA
Practice Address - State:MD
Practice Address - Zip Code:20646-5937
Practice Address - Country:US
Practice Address - Phone:301-751-5119
Practice Address - Fax:301-934-1291
Is Sole Proprietor?:Yes
Enumeration Date:2015-05-28
Last Update Date:2015-05-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD056101041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical