Provider Demographics
NPI:1124204441
Name:BYBEL, MICHELLE A (LCSW)
Entity Type:Individual
Prefix:MS
First Name:MICHELLE
Middle Name:A
Last Name:BYBEL
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:215 BROWN RD
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NY
Mailing Address - Zip Code:10941-3151
Mailing Address - Country:US
Mailing Address - Phone:914-263-4254
Mailing Address - Fax:
Practice Address - Street 1:70 EISENHOWER DR
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652-1462
Practice Address - Country:US
Practice Address - Phone:201-655-6864
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-01-16
Last Update Date:2011-10-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC048352001041C0700X
NY072155-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical