Healthcare Provider Details

I. General information

NPI: 1699687145
Provider Name (Legal Business Name): LYNNE M SIBILIA MA, CCC-SLP
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/21/2026
Last Update Date: 09/21/2026
Certification Date: 09/20/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

8 FAIRVIEW DR
NORTH CALDWELL NJ
07006-4515
US

IV. Provider business mailing address

8 FAIRVIEW DR
NORTH CALDWELL NJ
07006-4515
US

V. Phone/Fax

Practice location:
  • Phone: 973-670-6009
  • Fax:
Mailing address:
  • Phone: 973-670-6009
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number41YS00245100
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: