Individual
KINDRA HIBBARD
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
LCPC, LMHC
Contact information
Practice address
312 MILLER ST, LEWISTON, ID 83501-1944
(208) 750-1802
(208) 750-1803
Mailing address
2901 KNOLL CREST DR, LEWISTON, ID 83501-6707
(208) 750-1802
(208) 750-1803
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
LH60086695
WA
101YP2500X
Professional Counselor
Primary
LCPC 4160
ID
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
LCPC-4160
STATE LICENSURE
ID
01
—
LH60086695
STATE LICENSURE
WA
Enumeration date
04/13/2009
Last updated
04/20/2018
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