Tibaldi, Joan
Tibaldi, Joan is an sole proprietor health care provider with primary practice located at 612 Copperhead Cir , Saint Augustine FL 32092-2733. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Tibaldi, Joan can be contacted via phone (904) 679-4321.Contact Information
Primary practice address
612 Copperhead Cir
Saint Augustine FL 32092-2733
Phone: (904) 679-4321
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | R20522 | New York |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | SW15600 | Florida |
Profile Details
| NPI number | 1053476473 |
|---|---|
| LBN Legal business name | Tibaldi, Joan |
| Credentials | LCSW, BCD |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Dec 26th, 2006 |
| Last updated | Oct 11th, 2019 - about 5 years ago |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1053476473 | NPPES |
| New York | Other | 37793 | GHI PROVIDER # |
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