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General NPI Number Information
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NPI Number | 1689309775
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Entity Type | Individual
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Provider Name | KATHRYN KUBIK MSW, LSW
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Gender | Female
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Dates
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Enumeration Date | 07/21/2022
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Last Update Date | 07/21/2022
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Provider Practice Location Address
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Address Line | 4 FOREST AVE
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City | PARAMUS
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State | NJ
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Zip | 07652-5237
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Country | US
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Telephone | 201-588-3491
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Fax |
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Provider Business Mailing Address
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Address Line | 43 NEWARK AVE
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City | WESTWOOD
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State | NJ
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Zip | 07675-1916
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Country | US
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Telephone | 551-404-8753
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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 | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 44SL05927400
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License Number State | NJ
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