Provider Demographics
NPI:1831883644
Name:HIEBEL, ADAM
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:
Last Name:HIEBEL
Suffix:
Gender:
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:259 BRYN DU DR
Mailing Address - Street 2:
Mailing Address - City:GRANVILLE
Mailing Address - State:OH
Mailing Address - Zip Code:43023-1503
Mailing Address - Country:US
Mailing Address - Phone:740-334-8380
Mailing Address - Fax:
Practice Address - Street 1:360 E SOUTH WATER ST APT 2202
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60601-4133
Practice Address - Country:US
Practice Address - Phone:740-334-8380
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-06-05
Last Update Date:2025-05-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL071.011368103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical