Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
KELLY JEAN TIBBETTS, LICSW
Active Sole ProprietorKELLY JEAN TIBBETTS, LICSW is a Clinical Social Worker healthcare provider located in SPRING PARK, Minnesota. NPI 1992350367 is currently active in the NPPES registry. Verify at CMS.
Clinical Social Worker · SPRING PARK, MN
Registration Details
- NPI Number
- 1992350367
- Provider Type
- Individual
- Gender
- Female
- NPI Issued
- Aug 2, 2019 (7.0466520631428 yrs)
- Last Updated
- Jun 6, 2025
- License
-
22636 (MN)
- Sole Proprietor
- Yes
Practice Information
- Address
-
4154 SHORELINE DR STE 202SPRING PARK, MN, 553845610Browse MN providers · Browse ZIP 55384
- Phone
- 9524919450
- Primary Specialty
-
Clinical Social Worker
1041C0700X
Other Clinical Social Worker Providers in SPRING PARK, MN
| Name | Credential | NPI |
|---|---|---|
| JENNIE JEAN POGREBA | LICSW | 1316649775 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.