Samuel, Kibasa

Samuel, Kibasa is an sole proprietor health care provider with primary practice located at 169 Commack Rd # 1010 , Commack NY 11725-3442. She recently has 4 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Professional, Behavioral Health & Social Service Providers / Social Worker, Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is her primary health care specialty. Samuel, Kibasa can be contacted via phone (516) 430-7372.

Contact Information

Primary practice address
169 Commack Rd # 1010 Commack NY 11725-3442
Phone: (516) 430-7372
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 31589 New York
Behavioral Health & Social Service Providers / Professional 101YP2500X 4937560 New York
Behavioral Health & Social Service Providers / Social Worker 104100000X 72091813 New York
Behavioral Health & Social Service Providers / Clinical 1041C0700X 090232 New York

Profile Details

NPI number 1407227879
LBN Legal business name Samuel, Kibasa
Credentials LCSW, CASAC, SAP MAC
Entity Individual
Sole proprietor 1 Yes
Enumeration date Oct 12th, 2015
Last updated Feb 23rd, 2022 - about 2 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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