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General NPI Number Information
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NPI Number | 1427574748
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Entity Type | Individual
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Provider Name | WILLIAM THOMAS BIBB JR.
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Gender | Male
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Dates
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Enumeration Date | 08/17/2017
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 1675 ANSEL RD
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City | CLEVELAND
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State | OH
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Zip | 44106-4181
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Country | US
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Telephone | 216-299-7780
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Fax |
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Provider Business Mailing Address
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Address Line | 1675 ANSEL RD APT 1329
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City | CLEVELAND
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State | OH
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Zip | 44106-4175
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Country | US
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Telephone | 216-299-7780
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 103TH0100X
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Taxonomy Name | Health Service Psychologist
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License Number | 161717
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License Number State | OH
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Taxonomy #2
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Taxonomy Code | 174H00000X
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Taxonomy Name | Health Educator
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License Number | 161717
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License Number State | OH
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Taxonomy #3
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Taxonomy Code | 103TA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Psychologist
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License Number | 161717
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License Number State | OH
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Taxonomy #4
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | 161717
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License Number State | OH
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Taxonomy #5
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Taxonomy Code | 261QP0904X
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Taxonomy Name | Federal Public Health Clinic/Center
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License Number | 161717
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License Number State | OH
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Taxonomy #6
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Taxonomy Code | 225800000X
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Taxonomy Name | Recreation Therapist
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License Number | 161717
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License Number State | OH
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Taxonomy #7
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Taxonomy Code | 405300000X
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Taxonomy Name | Prevention Professional
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License Number | 161717
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License Number State | OH
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Taxonomy #8
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Taxonomy Code | 133NN1002X
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Taxonomy Name | Nutrition Education Nutritionist
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License Number | 161717
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License Number State | OH
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Taxonomy #9
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Taxonomy Code | 1744R1102X
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Taxonomy Name | Research Study Specialist
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License Number | 161717
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License Number State | OH
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Taxonomy #10
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Taxonomy Code | 171400000X
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Taxonomy Name | Health & Wellness Coach
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License Number | 161717
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License Number State | OH
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Taxonomy #11
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Taxonomy Code | 251K00000X
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Taxonomy Name | Public Health or Welfare Agency
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License Number | 161717
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License Number State | OH
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Taxonomy #12
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 161717
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License Number State | OH
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Taxonomy #13
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Taxonomy Code | 171M00000X
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Taxonomy Name | Case Manager/Care Coordinator
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License Number | 161717
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License Number State | OH
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Taxonomy #14
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Taxonomy Code | 208D00000X
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Taxonomy Name | General Practice Physician
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License Number | 161717
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License Number State | OH
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Taxonomy #15
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Taxonomy Code | 174400000X
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Taxonomy Name | Specialist
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License Number | 161717
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License Number State | OH
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