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General NPI Number Information
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NPI Number | 1447685839
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Entity Type | Organization
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Legal Business Name | BRAD SIBILLE LLC
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Dates
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Enumeration Date | 09/04/2013
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Last Update Date | 09/22/2022
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Provider Practice Location Address
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Address Line | 333 S MAIN ST
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City | OPELOUSAS
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State | LA
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Zip | 70570-6137
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Country | US
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Telephone | 337-945-1032
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Fax | 337-678-1893
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Provider Business Mailing Address
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Address Line | 333 S MAIN ST
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City | OPELOUSAS
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State | LA
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Zip | 70570-6137
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Country | US
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Telephone | 337-945-1032
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Fax | 337-678-1893
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Authorized Official
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Title or Position | PROVIDER
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Name | BRAD LOUIS SIBILLE
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Credential | MS LPC
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Telephone | 337-945-1032
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 5048
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License Number State | LA
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