Provider Demographics
NPI:1528094612
Name:GILMAN-FLEMING, LIBBY J (LCSW)
Entity type:Individual
Prefix:MRS
First Name:LIBBY
Middle Name:J
Last Name:GILMAN-FLEMING
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 1:32302 CAMINO CAPISTRANO
Mailing Address - Street 2:SUITE 202
Mailing Address - City:SAN JUAN CAPISTRANO
Mailing Address - State:CA
Mailing Address - Zip Code:92675-4501
Mailing Address - Country:US
Mailing Address - Phone:949-842-3250
Mailing Address - Fax:949-488-7793
Practice Address - Street 1:32302 CAMINO CAPISTRANO
Practice Address - Street 2:SUITE 202
Practice Address - City:SAN JUAN CAPISTRANO
Practice Address - State:CA
Practice Address - Zip Code:92675-4501
Practice Address - Country:US
Practice Address - Phone:949-842-3250
Practice Address - Fax:949-488-7793
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-23
Last Update Date:2009-01-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALCS205301041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical