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General NPI Number Information
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NPI Number | 1467888164
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Entity Type | Individual
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Provider Name | ALLISON HIBBARD LMFT, LAADC-CA
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Gender | Female
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Dates
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Enumeration Date | 09/25/2013
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Last Update Date | 01/24/2022
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Provider Practice Location Address
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Address Line | 2494 LAKE TAHOE BLVD STE B7
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City | SOUTH LAKE TAHOE
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State | CA
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Zip | 96150-7142
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Country | US
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Telephone | 530-600-6505
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Fax |
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Provider Business Mailing Address
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Address Line | PO BOX 19007
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City | S LAKE TAHOE
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State | CA
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Zip | 96151-0007
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Country | US
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Telephone | 530-600-6505
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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 | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | LCI12030518
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License Number State | CA
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Taxonomy #2
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 123915
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License Number State | CA
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Taxonomy #3
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Taxonomy Code | 101YA0400X
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Taxonomy Name | Addiction (Substance Use Disorder) Counselor
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License Number | 06577-PC
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License Number State | NV
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Taxonomy #4
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Taxonomy Code | 106H00000X
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Taxonomy Name | Marriage & Family Therapist
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License Number | 3308-R
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License Number State | NV
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