HEATHER RENEE IBACH LAC LSW NPI 1972829950

NPI Information

Heather Renee Ibach, LAC, LSW is an addiction (substance use disorder) counselor in Bismarck, ND with 6 years of experience. Heather Renee Ibach, LAC, LSW NPI is 1972829950. 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:

1237 W DIVIDE AVE
STE 5
BISMARCK, ND
ZIP 58501-208
Phone: (701) 328-8888
Fax: (701) 328-8900

The NPI 1972829950 is registered in the Medicare Provider, Enrollment, Chain and Ownership System (PECOS). The provider is legally eligible to order and refer Part B (Clinical Laboratory and Imaging), Durable Medical Equipment.

The enumeration date for this NPI number is 4/15/2010 and was last updated on 7/9/2012.

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:

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