Individual
CASEY RYAN TIBBS
Active
Sole proprietor
No
Provider details
NPI number
Gender
Man
Credential
LCSW
Contact information
Practice address
770 W RIDGE RD STE 220, WYTHEVILLE, VA 24382-1187
(276) 223-3202
Mailing address
770 W RIDGE RD, WYTHEVILLE, VA 24382-1187
(276) 223-3200
(276) 223-0617
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
0904013920
VA
Other
Enumeration date
04/29/2022
Last updated
04/29/2022
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