MEDICARE: MS. ASHLEY MARINO SIBIGA LAC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	37AC00441400	NJ

General Provider Information

NPI Number	:	1598172751
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MS. ASHLEY MARINO SIBIGA LAC

Provider Business Mailing Address
First Line	:	150 MORRISTOWN RD
Second Line	:
City	:	BERNARDSVILLE
State	:	NJ
Zip	:	07924-2626
Country	:	US
Telephone Number	:	732-982-2888
Fax Number	:	847-859-5885

Provider Business Practice Location Address
First Line	:	150 MORRISTOWN RD
Second Line	:
City	:	BERNARDSVILLE
State	:	NJ
Zip	:	07924-2626
Country	:	US
Telephone Number	:	732-982-2888
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/18/2014
Last Update Date	:	03/01/2024

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