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General NPI Number Information
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NPI Number | 1528218070
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Entity Type | Individual
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Provider Name | MELISSA LIPPMAN KILBRIDE LCSW, LICSW, LCSW-C
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Gender | Female
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Dates
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Enumeration Date | 09/22/2008
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Last Update Date | 10/24/2008
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Provider Practice Location Address
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Address Line | 64 NEW YORK AVE NE 4TH FLOOR
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City | WASHINGTON
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State | DC
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Zip | 20002-3320
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Country | US
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Telephone | 773-263-0436
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Fax |
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Provider Business Mailing Address
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Address Line | 1425 11TH ST NW UNIT 204
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City | WASHINGTON
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State | DC
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Zip | 20001-3302
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Country | US
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Telephone | 773-263-0536
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | LC50078577
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License Number State | DC
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 149.012392
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License Number State | IL
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Taxonomy #3
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 14350
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License Number State | MD
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Taxonomy #4
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 0904006897
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License Number State | VA
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