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Individual

MS. JESSICA SUSAN HIBBS

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
LCPC

Contact information

Practice address
10026 MAIN ST BLDG 1, BERLIN, MD 21811-3206
(410) 973-2211
(443) 782-0350
Mailing address
10026 MAIN ST BLDG 1, BERLIN, MD 21811-3206
(410) 973-2211
(443) 782-0350

Taxonomy

Speciality
Code
Description
License number
State
101Y00000X
Counselor
LGP9764
MD
101YP2500X
Professional Counselor
Primary
LC11740
MD

Other

Other identifiers
Code
Description
Identifier
Issuer
State
05
119591300
MD
01
LC11740
LICENSE
MD
Enumeration date
07/31/2019
Last updated
07/28/2021
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