Provider Demographics
NPI:1083590384
Name:JIBRIL, KARIM O (TLMSW)
Entity type:Individual
Prefix:
First Name:KARIM
Middle Name:O
Last Name:JIBRIL
Suffix:
Gender:M
Credentials:TLMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2020 N WOODLAWN ST STE 620
Mailing Address - Street 2:
Mailing Address - City:WICHITA
Mailing Address - State:KS
Mailing Address - Zip Code:67208-1887
Mailing Address - Country:US
Mailing Address - Phone:316-259-7508
Mailing Address - Fax:
Practice Address - Street 1:2020 N WOODLAWN ST STE 620
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67208-1887
Practice Address - Country:US
Practice Address - Phone:316-259-7508
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-08-12
Last Update Date:2025-08-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLMSW13567-T104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker