Provider Demographics
NPI:1871368878
Name:HIBBS, CARLA MICHELLE (LPC)
Entity type:Individual
Prefix:
First Name:CARLA
Middle Name:MICHELLE
Last Name:HIBBS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1349 N ARGONIA RD
Mailing Address - Street 2:
Mailing Address - City:MILTON
Mailing Address - State:KS
Mailing Address - Zip Code:67106-8012
Mailing Address - Country:US
Mailing Address - Phone:316-204-6484
Mailing Address - Fax:
Practice Address - Street 1:7926 W 21ST ST N
Practice Address - Street 2:
Practice Address - City:WICHITA
Practice Address - State:KS
Practice Address - Zip Code:67205-1742
Practice Address - Country:US
Practice Address - Phone:316-272-5502
Practice Address - Fax:316-462-5640
Is Sole Proprietor?:No
Enumeration Date:2023-11-20
Last Update Date:2023-12-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KSLPC04557101Y00000X, 101YM0800X, 101YP2500X
KS1331142121101YS0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YS0200XBehavioral Health & Social Service ProvidersCounselorSchool