Provider Demographics
NPI:1447909494
Name:KIRBY, CAROLINE ANNE (LMFT)
Entity type:Individual
Prefix:
First Name:CAROLINE
Middle Name:ANNE
Last Name:KIRBY
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:125 PROSPECT ST APT 6A
Mailing Address - Street 2:
Mailing Address - City:STAMFORD
Mailing Address - State:CT
Mailing Address - Zip Code:06901-1220
Mailing Address - Country:US
Mailing Address - Phone:978-857-3232
Mailing Address - Fax:
Practice Address - Street 1:220 5TH AVE FL 11
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-8017
Practice Address - Country:US
Practice Address - Phone:978-857-3232
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-18
Last Update Date:2022-03-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001920106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist