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Individual
MS. TINA WIBSTAD
Active
Individual
MS. TINA WIBSTAD
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCSW, LSSW, CADC III
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
12-06-70
OR
101YA0400X
Addiction (Substance Use Disorder) Counselor
509692
—
1041C0700X
Clinical Social Worker
Primary
L5975
OR
1041S0200X
School Social Worker
10517192
OR
Other
Enumeration date
09/16/2010
Last updated
08/19/2026
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