Individual provider Active NPI

Stanley E Hibbs, PH.D.

  • Psychologist
  • Atlanta, GA
National Provider Identifier
1720126329
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
PsychologistTaxonomy code 103T00000X
License
572 Issued in GA
Practice address
1864 Independence SQ
Suite a
Atlanta, GA 30338-5173
Phone
(770) 668-0350
Fax
(770) 668-0417
NPI assigned
Feb 3, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Psychologist 103T00000X 572 GA Primary

Addresses

Primary practice location

1864 Independence SQ
Suite a
Atlanta, GA 30338-5173

Mailing address

7590 Hunters Woods Dr
Atlanta, GA 30350-5628
Phone (770) 668-0350

Other identifiers 1

IdentifierTypeStateIssuer
00188856DMedicaidGA

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Doctor of Philosophy

State licenses

LicenseStateTypeSpecialty
572GAMDMarriage & Family Therapist

Practice roles

OrganizationSpecialtyStatusNew patients
WHG Psychological Services LLC CurrentSince Oct 18, 2021 Accepting new patients

Locations

1864 Independence Sq
Ste A
Dunwoody, GA 30338
Phone (770) 668-0350

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1170460800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1720126329",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "7590 HUNTERS WOODS DR",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303505628",
            "telephone_number": "770-668-0350",
            "fax_number": "770-668-0417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1864 INDEPENDENCE SQ",
            "address_2": "SUITE A",
            "city": "ATLANTA",
            "state": "GA",
            "postal_code": "303385173",
            "telephone_number": "770-668-0350",
            "fax_number": "770-668-0417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HIBBS",
        "first_name": "STANLEY",
        "middle_name": "E",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-02-03",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103T00000X",
            "taxonomy_group": "",
            "desc": "Psychologist",
            "state": "GA",
            "license": "572",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00188856D",
            "state": "GA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Atlanta, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.