Provider Demographics
NPI:1316271877
Name:ANDY SIBLEY COUNSELING SERVICES, INC.
Entity type:Organization
Organization Name:ANDY SIBLEY COUNSELING SERVICES, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT / PRACTITIONER
Authorized Official - Prefix:MR
Authorized Official - First Name:ANDY
Authorized Official - Middle Name:
Authorized Official - Last Name:SIBLEY
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT, LPC
Authorized Official - Phone:318-868-5008
Mailing Address - Street 1:920 PIERREMONT RD
Mailing Address - Street 2:SUITE 205
Mailing Address - City:SHREVEPORT
Mailing Address - State:LA
Mailing Address - Zip Code:71106-2079
Mailing Address - Country:US
Mailing Address - Phone:318-868-5008
Mailing Address - Fax:318-868-5051
Practice Address - Street 1:920 PIERREMONT RD
Practice Address - Street 2:SUITE 205
Practice Address - City:SHREVEPORT
Practice Address - State:LA
Practice Address - Zip Code:71106-2079
Practice Address - Country:US
Practice Address - Phone:318-868-5008
Practice Address - Fax:318-868-5051
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2009-09-30
Last Update Date:2009-09-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
LA830261QM0801X
LA2841261QM0801X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)