Provider Demographics
NPI:1720224611
Name:BIBBY, SALLY V (LCSW)
Entity Type:Individual
Prefix:
First Name:SALLY
Middle Name:V
Last Name:BIBBY
Suffix:
Gender:F
Credentials:LCSW
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Other - Last Name:
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Mailing Address - Street 1:6798 CROSSWINDS DR N STE B102
Mailing Address - Street 2:C/O FAMILY RESOURCES
Mailing Address - City:ST PETERSBURG
Mailing Address - State:FL
Mailing Address - Zip Code:33710-5476
Mailing Address - Country:US
Mailing Address - Phone:727-381-9400
Mailing Address - Fax:727-381-9181
Practice Address - Street 1:6798 CROSSWINDS DR N STE B102
Practice Address - Street 2:C/O FAMILY RESOURCES
Practice Address - City:ST PETERSBURG
Practice Address - State:FL
Practice Address - Zip Code:33710-5476
Practice Address - Country:US
Practice Address - Phone:727-381-9400
Practice Address - Fax:727-381-9181
Is Sole Proprietor?:No
Enumeration Date:2008-12-23
Last Update Date:2011-02-23
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
FLSW 69361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical