Provider Demographics
NPI:1205271384
Name:PAIGE-FIBBLE, REBECCA MARIE (LCSW)
Entity type:Individual
Prefix:MRS
First Name:REBECCA
Middle Name:MARIE
Last Name:PAIGE-FIBBLE
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2326 ANNUNCIATION ST
Mailing Address - Street 2:
Mailing Address - City:NEW ORLEANS
Mailing Address - State:LA
Mailing Address - Zip Code:70130-5402
Mailing Address - Country:US
Mailing Address - Phone:504-388-3115
Mailing Address - Fax:504-558-7744
Practice Address - Street 1:2326 ANNUNCIATION ST
Practice Address - Street 2:
Practice Address - City:NEW ORLEANS
Practice Address - State:LA
Practice Address - Zip Code:70130-5402
Practice Address - Country:US
Practice Address - Phone:504-388-3115
Practice Address - Fax:504-558-7744
Is Sole Proprietor?:Yes
Enumeration Date:2013-05-02
Last Update Date:2013-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA85051041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical