Provider Demographics
NPI:1235801226
Name:BIBBS-SAMUELS, PAULA KAY (LPC)
Entity Type:Individual
Prefix:
First Name:PAULA
Middle Name:KAY
Last Name:BIBBS-SAMUELS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:805 S IVORY ST
Mailing Address - Street 2:
Mailing Address - City:SLATON
Mailing Address - State:TX
Mailing Address - Zip Code:79364-5740
Mailing Address - Country:US
Mailing Address - Phone:806-790-6776
Mailing Address - Fax:
Practice Address - Street 1:5701 AVENUE P
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79412-3674
Practice Address - Country:US
Practice Address - Phone:806-747-3488
Practice Address - Fax:806-747-3219
Is Sole Proprietor?:Yes
Enumeration Date:2021-09-29
Last Update Date:2024-01-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101Y00000X, 101YM0800X
TX81777101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health