Organization
KIMBERLY A. KICK, LCSW & ASSOCIATES, LTD.
Active
Other names
Libertyville Insight & Behavioral Center
Organization subpart
No
Provider details
NPI number
Authorized official
DR. KIMBERLY A KICK PHD,MSW, LCSW (OWNER)
(847) 400-6204
Entity
Organization
Contact information
Practice address
709 N MILWAUKEE AVE, LIBERTYVILLE, IL 60048-1913
(847) 400-6204
(847) 327-1592
Mailing address
709 N MILWAUKEE AVE, LIBERTYVILLE, IL 60048-1913
(847) 400-6204
(847) 327-1592
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
060011046
IL
251S00000X
Community/Behavioral Health Agency
149-005107
IL
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
IL1548
PTAN
IL
Enumeration date
05/06/2013
Last updated
12/30/2014
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