Provider Demographics
NPI:1285933812
Name:DELCOURT, KIMBERLY D (MSW, LCSW)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:D
Last Name:DELCOURT
Suffix:
Gender:F
Credentials:MSW, LCSW
Other - Prefix:MS
Other - First Name:KIMBERLY
Other - Middle Name:D
Other - Last Name:CURTIS
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:KIMBERLY D MARTIN
Mailing Address - Street 1:509 W MCKINLEY AVE
Mailing Address - Street 2:STE 3
Mailing Address - City:MISHAWAKA
Mailing Address - State:IN
Mailing Address - Zip Code:46545-5564
Mailing Address - Country:US
Mailing Address - Phone:574-277-0274
Mailing Address - Fax:574-271-7202
Practice Address - Street 1:509 W MCKINLEY AVE
Practice Address - Street 2:STE 3
Practice Address - City:MISHAWAKA
Practice Address - State:IN
Practice Address - Zip Code:46545-5564
Practice Address - Country:US
Practice Address - Phone:574-254-0229
Practice Address - Fax:574-254-0188
Is Sole Proprietor?:No
Enumeration Date:2011-03-22
Last Update Date:2018-10-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X
IN34007827A1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101Y00000XBehavioral Health & Social Service ProvidersCounselor