Provider Demographics
NPI:1871909473
Name:KILBURG, HELEN (LSW)
Entity type:Individual
Prefix:
First Name:HELEN
Middle Name:
Last Name:KILBURG
Suffix:
Gender:F
Credentials:LSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:114 WENATCHEE PL
Mailing Address - Street 2:
Mailing Address - City:HEBRON
Mailing Address - State:IN
Mailing Address - Zip Code:46341-7204
Mailing Address - Country:US
Mailing Address - Phone:219-613-8514
Mailing Address - Fax:
Practice Address - Street 1:114 WENATCHEE PL
Practice Address - Street 2:
Practice Address - City:HEBRON
Practice Address - State:IN
Practice Address - Zip Code:46341-7204
Practice Address - Country:US
Practice Address - Phone:219-613-8514
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-07-03
Last Update Date:2014-07-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN33000341A104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker