Doctor Name: | MR. VICKI KULBERG |
NPI Number: | 1083708788 |
Entity Type Code: | Individual (1) |
Gender: | F |
Credentials: | LCSW |
License Number: | RO43220 |
Business Practice Address: | 1 Old Country Road Suite 295 Carle Place, NY - 11514 |
Business Phone Number: | 5167390957 |
Business Fax Number: | 5167415683 |
Mailing Address: | 133 W#. Broadway, LONG BEACH |
State: | NY |
Postal Code: | 11514 |
Phone Number: | 5168971888 |
Fax Number: | |
NPI Enumeration Date: | 10/03/2006 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | RO43220 |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | NY |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Social Worker |
Taxonomy Specialization: | Clinical |
Taxonomy Definition: | A social worker who holds a master |