Provider Demographics
NPI:1184053969
Name:GIBA, SARA STEVEE (MA, LMHC, MHP)
Entity type:Individual
Prefix:
First Name:SARA
Middle Name:STEVEE
Last Name:GIBA
Suffix:
Gender:F
Credentials:MA, LMHC, MHP
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2821 MISSION HILL RD
Mailing Address - Street 2:
Mailing Address - City:TULALIP
Mailing Address - State:WA
Mailing Address - Zip Code:98271-9706
Mailing Address - Country:US
Mailing Address - Phone:360-716-4347
Mailing Address - Fax:
Practice Address - Street 1:2821 MISSION HILL RD
Practice Address - Street 2:
Practice Address - City:TULALIP
Practice Address - State:WA
Practice Address - Zip Code:98271-9706
Practice Address - Country:US
Practice Address - Phone:360-716-4347
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2013-11-02
Last Update Date:2015-02-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
WAMC60298256101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health