Joshua Jibben, LCDC-I

Primary specialty

Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X

License

47072 Issued in TX

Practice address

3553 W Houston Harte Expy
San Angelo, TX 76901-2664

Phone

(325) 224-7236

NPI assigned

Jun 7, 2021

Sex

Male

Sole proprietor

No

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Alcohol & Drug Abuse Council for the Concho Valley

  • Substance Use Disorder Rehabilitation Clinic/Center
  • San Angelo, TX
  • NPI 1093031148
  NPD (past)
• Alcohol and Drug Abuse Council for the Concho Valley

  • Substance Abuse Rehabilitation Facility
  • San Angelo, TX
  • NPI 1053867267
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1623024000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1623024000000",
    "number": "1013584259",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3553 W HOUSTON HARTE EXPY",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769012664",
            "telephone_number": "325-224-3481"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3553 W HOUSTON HARTE EXPY",
            "city": "SAN ANGELO",
            "state": "TX",
            "postal_code": "769012664",
            "telephone_number": "325-224-7236"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "JIBBEN",
        "first_name": "JOSHUA",
        "name_prefix": "Mr.",
        "credential": "LCDC-I",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-06-07",
        "last_updated": "2021-06-07",
        "certification_date": "2021-06-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "TX",
            "license": "47072",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Joe Mac Jeffers, ED.D.
• Jose Jenks, PHARMD
• Jennifer M Moss
• Thomas S Jeter, MD, DDS
• Tresea M Jeter, FNP-C
• Jim Dandy Medical Inc
• Jim W. Collier, Dcpa
• Lydia J Jimenez, MS
• Havalo Kaye Jo Hanson, P.T.
• Joe M Jeffers

• Addiction (Substance Use Disorder) Counselor in San Angelo, TX
• Providers in San Angelo, TX by specialty
• Addiction (Substance Use Disorder) Counselor in Texas

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 7, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.