Provider Demographics
NPI:1396901989
Name:HYBLE, DENISE (LMFT)
Entity type:Individual
Prefix:
First Name:DENISE
Middle Name:
Last Name:HYBLE
Suffix:
Gender:F
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:205 N COLLEGE AVE STE 615
Mailing Address - Street 2:
Mailing Address - City:BLOOMINGTON
Mailing Address - State:IN
Mailing Address - Zip Code:47404-3956
Mailing Address - Country:US
Mailing Address - Phone:812-334-2858
Mailing Address - Fax:
Practice Address - Street 1:205 N COLLEGE AVE STE 615
Practice Address - Street 2:
Practice Address - City:BLOOMINGTON
Practice Address - State:IN
Practice Address - Zip Code:47404-3956
Practice Address - Country:US
Practice Address - Phone:812-334-2858
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-02
Last Update Date:2008-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IN3900069A101YM0800X
IN35000950106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health