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General NPI Number Information
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NPI Number | 1891981791
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Entity Type | Individual
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Provider Name | BRAD LOUIS SIBILLE MA, LPC-S
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Gender | Male
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Dates
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Enumeration Date | 09/24/2007
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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 |
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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 | 0008369
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License Number State | OH
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Taxonomy #2
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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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