Provider Demographics
NPI:1528113206
Name:STRIBLING, KIMBERLY IRIS (LCSW)
Entity type:Individual
Prefix:MRS
First Name:KIMBERLY
Middle Name:IRIS
Last Name:STRIBLING
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 1:621 W MAIN ST
Mailing Address - Street 2:
Mailing Address - City:PURCELLVILLE
Mailing Address - State:VA
Mailing Address - Zip Code:20132-3012
Mailing Address - Country:US
Mailing Address - Phone:540-338-3332
Mailing Address - Fax:
Practice Address - Street 1:621 W MAIN ST
Practice Address - Street 2:
Practice Address - City:PURCELLVILLE
Practice Address - State:VA
Practice Address - Zip Code:20132-3012
Practice Address - Country:US
Practice Address - Phone:703-669-9672
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2007-01-24
Last Update Date:2013-09-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
VA09040055811041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
VA190001169Medicare ID - Type Unspecified
VA190001169Medicare PIN