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NPI Code Detail

MEDICARE: KIBIBI LATEEF WOOD-MONTGOMERY CSW

MEDICARE: KIBIBI LATEEF WOOD-MONTGOMERY CSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
1104100000XSocial Worker7115KY
21041C0700XClinical Social Worker34011446AIN

General Provider Information

NPI Number : 1487261996
Entity Type Code : Individual
Provider Name (Legal Business Name) : KIBIBI LATEEF WOOD-MONTGOMERY CSW
Provider Business Mailing Address
First Line : 1232 SPORTSMAN DR
Second Line :
City : JEFFERSONVILLE
State : IN
Zip : 47130-6151
Country : US
Telephone Number : 502-500-3327
Fax Number :
Provider Business Practice Location Address
First Line : 2820 GRANT LINE RD # 10
Second Line :
City : NEW ALBANY
State : IN
Zip : 47150-2494
Country : US
Telephone Number : 812-981-2594
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/29/2020
Last Update Date : 02/23/2026

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Directions to “ KIBIBI LATEEF WOOD-MONTGOMERY CSW” Practice Location

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