Provider Demographics
NPI:1083484521
Name:TIBSHERANY, DENA NICOLE (LMSW)
Entity Type:Individual
Prefix:
First Name:DENA
Middle Name:NICOLE
Last Name:TIBSHERANY
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:DENA
Other - Middle Name:NICOLE
Other - Last Name:HICKMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2820 S ALMA SCHOOL RD STE 18-690
Mailing Address - Street 2:
Mailing Address - City:CHANDLER
Mailing Address - State:AZ
Mailing Address - Zip Code:85286-4392
Mailing Address - Country:US
Mailing Address - Phone:602-299-0789
Mailing Address - Fax:
Practice Address - Street 1:705 E SHEFFIELD AVE
Practice Address - Street 2:
Practice Address - City:GILBERT
Practice Address - State:AZ
Practice Address - Zip Code:85296-4118
Practice Address - Country:US
Practice Address - Phone:480-750-9412
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-01-05
Last Update Date:2024-01-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
AZLMSW-155421041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical