Provider Demographics
NPI:1629831953
Name:BIBBS, AKWASIBA FERRELL-CARTER
Entity Type:Individual
Prefix:MR
First Name:AKWASIBA
Middle Name:FERRELL-CARTER
Last Name:BIBBS
Suffix:
Gender:M
Credentials:
Other - Prefix:MR
Other - First Name:KWASI
Other - Middle Name:
Other - Last Name:BIBBS
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:3655 E 116TH ST
Mailing Address - Street 2:
Mailing Address - City:CLEVELAND
Mailing Address - State:OH
Mailing Address - Zip Code:44105-2515
Mailing Address - Country:US
Mailing Address - Phone:216-415-9849
Mailing Address - Fax:
Practice Address - Street 1:3793 GREEN RD
Practice Address - Street 2:
Practice Address - City:BEACHWOOD
Practice Address - State:OH
Practice Address - Zip Code:44122-5705
Practice Address - Country:US
Practice Address - Phone:216-232-5302
Practice Address - Fax:216-393-3690
Is Sole Proprietor?:No
Enumeration Date:2024-01-31
Last Update Date:2024-01-31
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes171M00000XOther Service ProvidersCase Manager/Care Coordinator
No175T00000XOther Service ProvidersPeer Specialist