Provider Demographics
NPI:1497193445
Name:SIBLEY, DONALD R JR (LCSW-R)
Entity type:Individual
Prefix:MR
First Name:DONALD
Middle Name:R
Last Name:SIBLEY
Suffix:JR
Gender:M
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:76 BROAD AVE
Mailing Address - Street 2:
Mailing Address - City:BINGHAMTON
Mailing Address - State:NY
Mailing Address - Zip Code:13904-1406
Mailing Address - Country:US
Mailing Address - Phone:607-237-0005
Mailing Address - Fax:607-217-4253
Practice Address - Street 1:76 BROAD AVE
Practice Address - Street 2:
Practice Address - City:BINGHAMTON
Practice Address - State:NY
Practice Address - Zip Code:13904-1406
Practice Address - Country:US
Practice Address - Phone:607-237-0005
Practice Address - Fax:607-217-4253
Is Sole Proprietor?:Yes
Enumeration Date:2013-06-12
Last Update Date:2025-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY087178-1104100000X
NY084556104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker