Provider Demographics
NPI:1407065303
Name:TEBBE, SANDRA A (LPCC, LICDC)
Entity Type:Individual
Prefix:MRS
First Name:SANDRA
Middle Name:A
Last Name:TEBBE
Suffix:
Gender:F
Credentials:LPCC, LICDC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16195 W POE RD
Mailing Address - Street 2:
Mailing Address - City:BOWLING GREEN
Mailing Address - State:OH
Mailing Address - Zip Code:43402-9128
Mailing Address - Country:US
Mailing Address - Phone:419-352-7745
Mailing Address - Fax:419-423-9877
Practice Address - Street 1:232 W HARDIN ST
Practice Address - Street 2:
Practice Address - City:FINDLAY
Practice Address - State:OH
Practice Address - Zip Code:45840-3106
Practice Address - Country:US
Practice Address - Phone:419-423-7812
Practice Address - Fax:419-423-9877
Is Sole Proprietor?:Yes
Enumeration Date:2007-05-21
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OH872324101YA0400X
OHE1735101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Not Answered101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Not Answered101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health