Provider Demographics
NPI:1700300712
Name:HIBBS, ALLISON (LCSW)
Entity Type:Individual
Prefix:MS
First Name:ALLISON
Middle Name:
Last Name:HIBBS
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 1:315 E 72ND ST APT 17J
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10021-4673
Mailing Address - Country:US
Mailing Address - Phone:203-520-5979
Mailing Address - Fax:
Practice Address - Street 1:315 E 72ND ST APT 17J
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10021-4673
Practice Address - Country:US
Practice Address - Phone:203-520-5979
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2017-08-01
Last Update Date:2022-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY100978-1104100000X
NY0938111041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker