Kelly Jean Tibbetts, LICSW
NPI #1992350367 in Spring Park, Minnesota
Provider Information
- NPI Number
- 1992350367
- Entity Type
- Individual
- Name
- Kelly Jean Tibbetts, LICSW
- Gender
- Not Specified
- Sole Proprietor
- Yes
- Primary Specialty
- Social Worker - Clinical
- Credential
- LICSW
- Enumeration Date
- Aug 2, 2019
- Last Updated
- Jun 6, 2025
Practice Location
- Address
- 4154 SHORELINE DR STE 202
- City
- Spring Park
- State
- Minnesota
- ZIP Code
- 55384-5610
- Phone
- (952) 491-9450
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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