MEDICARE: DR. WARREN WILLIAM SIBILLA JR. PH.D.

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	102L00000X	Psychoanalyst
2	103TC0700X	Clinical Psychologist	20040799	IN

General Provider Information

NPI Number	:	1871790121
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	DR. WARREN WILLIAM SIBILLA JR. PH.D.

Provider Business Mailing Address
First Line	:	105 E JEFFERSON BLVD
Second Line	:	SUITE 500
City	:	SOUTH BEND
State	:	IN
Zip	:	46601-1922
Country	:	US
Telephone Number	:	574-232-4453
Fax Number	:	574-232-7718

Provider Business Practice Location Address
First Line	:	105 E JEFFERSON BLVD
Second Line	:	SUITE 500
City	:	SOUTH BEND
State	:	IN
Zip	:	46601-1922
Country	:	US
Telephone Number	:	574-232-4453
Fax Number	:	574-232-7718

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	06/29/2007
Last Update Date	:	09/11/2025

Similar Medicare Providers

1518955434 — MR. MARKUS K JACKSON LCSW
Practice Location Address:

105 E JEFFERSON BLVD , SUITE 700
SOUTH BEND, IN
46601-1922

Practice Phone: 574-232-2255
Practice Fax: 574-287-9377

1275521106 — MRS. LANI C VIVIRITO LCSW
Practice Location Address:

105 E JEFFERSON BLVD , SUITE 700
SOUTH BEND, IN
46601-1922

Practice Phone: 574-232-2255
Practice Fax: 574-287-9377

1104815034 — MRS. KATHY BYLER MSW
Practice Location Address:

105 E JEFFERSON BLVD , SUITE 700
SOUTH BEND, IN
46601-1922

Practice Phone: 574-232-2255
Practice Fax: 574-287-9377

1508855420 — MRS. TINA MILLER MSW
Practice Location Address:

105 E JEFFERSON BLVD , SUITE 700
SOUTH BEND, IN
46601-1922

Practice Phone: 574-232-2255
Practice Fax: 574-287-9377

1740633239 — JULIE PERRON LMFTA
Practice Location Address:

105 E JEFFERSON BLVD , STE 310
SOUTH BEND, IN
46601-1922

Practice Phone: 574-383-5859
Practice Fax:

1174078836 — WAV MARKETING GROUP LLC
Practice Location Address:

105 E JEFFERSON BLVD , STE 500
SOUTH BEND, IN
46601-1922

Practice Phone: 574-217-3508
Practice Fax:

Directions to “ DR. WARREN WILLIAM SIBILLA JR. PH.D.” Practice Location

Language	Start Address	Practice Location

These directions are for planning purposes only. You may find that construction projects, traffic, or other events may cause road conditions to differ from the map results.

Copyright © 2007-2025 (Powered by Swiss Vault Engine), all rights reserved. HIPAA liability, trademark, document use and software licensing rules apply. All registered trademarks, used in the content, are the property of their owners. Your interactions with this site are in accordance with our Terms of Use and Privacy Policy.