Provider Demographics
NPI:1366285447
Name:GILL, KIMBERLEE (LMSW)
Entity type:Individual
Prefix:
First Name:KIMBERLEE
Middle Name:
Last Name:GILL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5108 BROADWAY STE 220
Mailing Address - Street 2:
Mailing Address - City:SAN ANTONIO
Mailing Address - State:TX
Mailing Address - Zip Code:78209-5728
Mailing Address - Country:US
Mailing Address - Phone:210-501-9869
Mailing Address - Fax:
Practice Address - Street 1:5108 BROADWAY STE 220
Practice Address - Street 2:
Practice Address - City:SAN ANTONIO
Practice Address - State:TX
Practice Address - Zip Code:78209-5728
Practice Address - Country:US
Practice Address - Phone:210-501-9869
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2024-06-17
Last Update Date:2024-06-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker