Provider Demographics
NPI:1851593255
Name:HIBBARD, SARAH S (CADC)
Entity Type:Individual
Prefix:
First Name:SARAH
Middle Name:S
Last Name:HIBBARD
Suffix:
Gender:F
Credentials:CADC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1000 US HWY 14 W
Mailing Address - Street 2:
Mailing Address - City:RICHLAND CENTER
Mailing Address - State:WI
Mailing Address - Zip Code:53581-1312
Mailing Address - Country:US
Mailing Address - Phone:608-647-6384
Mailing Address - Fax:608-647-8867
Practice Address - Street 1:1000 US HWY 14 W
Practice Address - Street 2:
Practice Address - City:RICHLAND CENTER
Practice Address - State:WI
Practice Address - Zip Code:53581-1312
Practice Address - Country:US
Practice Address - Phone:608-647-6384
Practice Address - Fax:608-647-8867
Is Sole Proprietor?:No
Enumeration Date:2007-06-05
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
Provider Identifiers
StateIdentifier IDID TypeIssuer
WI39382100Medicaid