MS. KATHERINE ANNA DIBB SAC NPI 1629245725

NPI Information

NPI: 1629245725
Provider Name: MS. KATHERINE ANNA DIBB, SAC
Classification: Counselor - 101YA0400X
Entity Type: Individual

Specialization: Addiction (Substance Use Disorder)

Address:
4757 N 76TH ST
MILWAUKEE, WI
ZIP 53218
Phone: (414) 358-5381
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MS. Katherine Anna Dibb, SAC is an addiction (substance use disorder) counselor in Milwaukee, WI. MS. Katherine Anna Dibb, SAC NPI is 1629245725. The provider is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business location address is:

4757 N 76TH ST
MILWAUKEE, WI
ZIP 53218-732
Phone: (414) 358-5381
Fax: (414) 358-5005

The enumeration date for this NPI number is 5/8/2008 and was last updated on 5/8/2008.

Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.	Taxonomy Code	Taxonomy Clasification	Taxonomy Specialization	License Number	License State	Primary
1	101YA0400X	Counselor	Addiction (Substance Use Disorder)	15361131	WISCONSIN	Yes

Other Identifiers

The following information regarding additional identifiers associated to this NPI record includes the other identifier number, identifier type, identifier state and issuer.

No.	Other Provider Identifier	Other Provider Identifier Type	Other Provider Identifier State	Other Provider Identifier Issuer
1	15361131	OTHER	WISCONSIN	WISCONSIN DEPARTMENT OF REGULATUION AND LICENSING
2	39178900	MEDICAID	WISCONSIN

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 11/14/2023

NPI Synchronization or Removal

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