Individual provider · Type 1 NPI

Elizabeth G. Gamboa-Reynolds, LCSW

Clinical Social Worker · Kenosha, WI

NPI number 1689255291 Active

Practice location

2108 63rd St
Kenosha, WI 53143-4454

Call (262) 652-2406 Map

Mailing address

6233 39th Ave
Kenosha, WI 53142-7015

Specialties and licenses

TaxonomyCodeLicense
Counselor 101Y00000X131302121 (WI)
Clinical Social Worker Primary 1041C0700X9880 (WI)

Clinical Social Worker: A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpers…

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About NPI 1689255291

Elizabeth G. Gamboa-Reynolds, LCSW's National Provider Identifier is 1689255291, issued on Apr 15, 2021. The primary taxonomy on file is Clinical Social Worker (1041C0700X), and the practice location is in Kenosha, WI. The record was last updated on Feb 21, 2022.