Provider Demographics
NPI:1306510276
Name:HIBBS, LAURA DIANNE (LPCC)
Entity type:Individual
Prefix:
First Name:LAURA
Middle Name:DIANNE
Last Name:HIBBS
Suffix:
Gender:F
Credentials:LPCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 15681
Mailing Address - Street 2:
Mailing Address - City:RIO RANCHO
Mailing Address - State:NM
Mailing Address - Zip Code:87174-0681
Mailing Address - Country:US
Mailing Address - Phone:505-317-3792
Mailing Address - Fax:505-926-6117
Practice Address - Street 1:8214 2ND ST NW STE C
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87114-1091
Practice Address - Country:US
Practice Address - Phone:505-317-3792
Practice Address - Fax:505-792-6611
Is Sole Proprietor?:No
Enumeration Date:2021-08-04
Last Update Date:2024-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCTB-2024-0687101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional