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General NPI Number Information
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NPI Number | 1881494383
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Entity Type | Organization
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Legal Business Name | KIBBY CHRISTIAN COUNSELING LLC
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Dates
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Enumeration Date | 03/14/2025
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Last Update Date | 04/26/2025
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Provider Practice Location Address
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Address Line | 11051 AUTUMN LN
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City | FOSTORIA
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State | OH
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Zip | 44830-3309
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Country | US
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Telephone | 725-236-0525
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Fax | 725-236-0525
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Provider Business Mailing Address
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Address Line | 11051 AUTUMN LN
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City | FOSTORIA
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State | OH
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Zip | 44830-3309
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Country | US
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Telephone | 725-236-0525
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Fax | 725-236-0525
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Authorized Official
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Title or Position | CEO
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Name | MR. ANDRE WILLIAMS
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Credential | LCPC,LPCC
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Telephone | 725-236-0525
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0855X
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Taxonomy Name | Adolescent and Children Mental Health Clinic/Center
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 261QM0850X
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Taxonomy Name | Adult Mental Health Clinic/Center
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License Number |
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License Number State |
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