Provider Demographics
NPI:1548454069
Name:TIBBITS, LORI M (LPC)
Entity type:Individual
Prefix:MRS
First Name:LORI
Middle Name:M
Last Name:TIBBITS
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1613 WALNUT ST
Mailing Address - Street 2:
Mailing Address - City:CARY
Mailing Address - State:NC
Mailing Address - Zip Code:27511-5928
Mailing Address - Country:US
Mailing Address - Phone:919-696-7010
Mailing Address - Fax:
Practice Address - Street 1:1613 WALNUT ST
Practice Address - Street 2:
Practice Address - City:CARY
Practice Address - State:NC
Practice Address - Zip Code:27511-5928
Practice Address - Country:US
Practice Address - Phone:919-696-7010
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-28
Last Update Date:2007-08-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NC6632101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional