Provider Demographics
NPI:1518446327
Name:HIBBARD, MELINDA MARIE (LMHC)
Entity Type:Individual
Prefix:MS
First Name:MELINDA
Middle Name:MARIE
Last Name:HIBBARD
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:MS
Other - First Name:MELINDA
Other - Middle Name:MARIE
Other - Last Name:COHEN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2180 NORCOR AVE STE D
Mailing Address - Street 2:
Mailing Address - City:CORALVILLE
Mailing Address - State:IA
Mailing Address - Zip Code:52241-9748
Mailing Address - Country:US
Mailing Address - Phone:319-409-7759
Mailing Address - Fax:
Practice Address - Street 1:2180 NORCOR AVE STE D
Practice Address - Street 2:
Practice Address - City:CORALVILLE
Practice Address - State:IA
Practice Address - Zip Code:52241-9748
Practice Address - Country:US
Practice Address - Phone:319-409-7759
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-08-13
Last Update Date:2023-03-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA091622101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health