Healthcare Provider Details

I. General information

NPI: 1427242288
Provider Name (Legal Business Name): GRETCHEN EHRET HIBBEN GRETCHEN HIBBEN
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: GRETCHEN EHRET GRETCHEN HIBBEN

II. Dates (important events)

Enumeration Date: 09/04/2007
Last Update Date: 07/17/2026
Certification Date: 07/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

258 MAIN ST STE B4
BUZZARDS BAY MA
02532-3251
US

IV. Provider business mailing address

PO BOX 1054
BARNSTABLE MA
02630-2054
US

V. Phone/Fax

Practice location:
  • Phone: 508-743-5678
  • Fax: 508-743-5699
Mailing address:
  • Phone: 508-479-0620
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number8228
License Number StateMA

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: