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General NPI Number Information
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NPI Number | 1629057617
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Entity Type | Individual
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Provider Name | CAROL H KIBBEE LPC
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Gender | Female
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Dates
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Enumeration Date | 01/10/2006
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Last Update Date | 07/24/2007
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Provider Practice Location Address
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Address Line | 3103 CLEARWATER DR SUITE B
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City | PRESCOTT
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State | AZ
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Zip | 86305
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Country | US
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Telephone | 928-717-2505
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Fax | 928-717-2504
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Provider Business Mailing Address
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Address Line | 1818 SHERWOOD DR
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City | PRESCOTT
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State | AZ
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Zip | 86303
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Country | US
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Telephone | 928-717-2505
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Fax | 928-717-2504
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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 | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | 12139
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License Number State | AZ
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Taxonomy #2
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Taxonomy Code | 101Y00000X
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Taxonomy Name | Counselor
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License Number | LPC12139
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License Number State | AZ
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