Provider Demographics
NPI:1851623847
Name:IBLE, CLAUDETTE DENISE (LMSW)
Entity Type:Individual
Prefix:MS
First Name:CLAUDETTE
Middle Name:DENISE
Last Name:IBLE
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:MS
Other - First Name:CLAUDETTE
Other - Middle Name:DENISE
Other - Last Name:IBLE
Other - Suffix:
Other - Last Name Type:Professional Name
Other - Credentials:LMSW
Mailing Address - Street 1:17 W 182ND ST
Mailing Address - Street 2:APT 2J
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10453-1727
Mailing Address - Country:US
Mailing Address - Phone:718-364-3186
Mailing Address - Fax:718-579-5310
Practice Address - Street 1:234 E 149TH ST
Practice Address - Street 2:SOCIAL WORK OFFICE 1B2
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10451-5504
Practice Address - Country:US
Practice Address - Phone:718-579-5657
Practice Address - Fax:718-579-5310
Is Sole Proprietor?:Yes
Enumeration Date:2010-02-02
Last Update Date:2010-02-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070347282N00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes282N00000XHospitalsGeneral Acute Care Hospital