Provider Demographics
NPI:1861078321
Name:GILROY, KIMBERLY M (LCSW)
Entity type:Individual
Prefix:
First Name:KIMBERLY
Middle Name:M
Last Name:GILROY
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:28 WORLIDGE CT UNIT 1
Mailing Address - Street 2:
Mailing Address - City:FREEHOLD
Mailing Address - State:NJ
Mailing Address - Zip Code:07728-4903
Mailing Address - Country:US
Mailing Address - Phone:917-815-0344
Mailing Address - Fax:
Practice Address - Street 1:28 WORLIDGE CT UNIT 1
Practice Address - Street 2:
Practice Address - City:FREEHOLD
Practice Address - State:NJ
Practice Address - Zip Code:07728-4903
Practice Address - Country:US
Practice Address - Phone:917-815-0344
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-23
Last Update Date:2024-04-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC05676700101YM0800X
NJ18610783211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical