Provider Demographics
NPI:1528175767
Name:ALBERT, KIMBERLY D (LCSW-C)
Entity type:Individual
Prefix:MS
First Name:KIMBERLY
Middle Name:D
Last Name:ALBERT
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:MISS
Other - First Name:KIMBEELY
Other - Middle Name:ANN
Other - Last Name:DEMASTUA
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:1017 QUINCE LN
Mailing Address - Street 2:
Mailing Address - City:BEL AIR
Mailing Address - State:MD
Mailing Address - Zip Code:21014-5372
Mailing Address - Country:US
Mailing Address - Phone:410-638-2368
Mailing Address - Fax:410-889-3616
Practice Address - Street 1:3811 CANTERBURY RD
Practice Address - Street 2:
Practice Address - City:BALTIMORE
Practice Address - State:MD
Practice Address - Zip Code:21218-2340
Practice Address - Country:US
Practice Address - Phone:410-889-4908
Practice Address - Fax:410-889-3616
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-24
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD121381041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical