NPI Code Detail JSON Logo

1205236841 NPI number — AMY SUZANNE TIBBLES LMHC, LCPC

NPI Number: 1205236841
Health Care Provider/Practitioner: AMY SUZANNE TIBBLES LMHC, LCPC

Information about “1205236841” NPI (AMY SUZANNE TIBBLES LMHC, LCPC) exists in 1205236841 in HTML format HTML  |  1205236841 in plain Text format TXT  |  1205236841 in PDF (Portable Document Format) PDF  |  1205236841 in an XML format XML  formats.

NPI Number : 1205236841 – JSON Data Format

                
{
  "Npi": {
    "NPI": "1205236841",
    "EntityType": "Individual",
    "ReplacementNPI": null,
    "EIN": null,
    "IsSoleProprietor": "N",
    "IsOrgSubpart": null,
    "ParentOrgLBN": null,
    "ParentOrgTIN": null,
    "OrgName": null,
    "LastName": "TIBBLES",
    "FirstName": "AMY",
    "MiddleName": "SUZANNE",
    "NamePrefix": null,
    "NameSuffix": null,
    "Credential": "LMHC, LCPC",
    "OtherOrgName": null,
    "OtherOrgNameTypeCode": null,
    "OtherLastName": null,
    "OtherFirstName": null,
    "OtherMiddleName": null,
    "OtherNamePrefix": null,
    "OtherNameSuffix": null,
    "OtherCredential": null,
    "OtherLastNameTypeCode": null,
    "FirstLineMailingAddress": "13760 TIBBLES LN",
    "SecondLineMailingAddress": null,
    "MailingAddressCityName": "ANACORTES",
    "MailingAddressStateName": "WA",
    "MailingAddressPostalCode": "98221-8236",
    "MailingAddressCountryCode": "US",
    "MailingAddressTelephoneNumber": "360-770-7634",
    "MailingAddressFaxNumber": null,
    "FirstLinePracticeLocationAddress": "1019 10TH ST",
    "SecondLinePracticeLocationAddress": null,
    "PracticeLocationAddressCityName": "ANACORTES",
    "PracticeLocationAddressStateName": "WA",
    "PracticeLocationAddressPostalCode": "98221-4139",
    "PracticeLocationAddressCountryCode": "US",
    "PracticeLocationAddressTelephoneNumber": "360-770-7634",
    "PracticeLocationAddressFaxNumber": null,
    "EnumerationDate": "09/02/2014",
    "LastUpdateDate": "05/14/2025",
    "NPIDeactivationReasonCode": null,
    "NPIDeactivationReason": null,
    "NPIDeactivationDate": null,
    "NPIReactivationDate": null,
    "GenderCode": "F",
    "Gender": "Female",
    "AuthorizedOfficialLastName": null,
    "AuthorizedOfficialFirstName": null,
    "AuthorizedOfficialMiddleName": null,
    "AuthorizedOfficialTitle": null,
    "AuthorizedOfficialNamePrefix": null,
    "AuthorizedOfficialNameSuffix": null,
    "AuthorizedOfficialCredential": null,
    "AuthorizedOfficialTelephoneNumber": null,
    "Taxonomies": {
      "Taxonomy": [
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "BBH-LCPC-LIC50714",
          "LicenseNumberStateCode": "MT",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101YM0800X",
          "TaxonomyName": "Mental Health Counselor",
          "LicenseNumber": "LH60851405",
          "LicenseNumberStateCode": "WA",
          "PrimaryTaxonomySwitch": "N"
        },
        {
          "TaxonomyCode": "101Y00000X",
          "TaxonomyName": "Counselor",
          "LicenseNumber": null,
          "LicenseNumberStateCode": null,
          "PrimaryTaxonomySwitch": "Y"
        }
      ]
    },
    "HealthcareProviderTaxonomyGroups": null
  }
}
                
            

Copyright © 2007-2026 Data Labs Health. All rights reserved.