Provider Demographics
NPI:1003958133
Name:LIBBY, LYNN MARY (EDS,LPC)
Entity Type:Individual
Prefix:MRS
First Name:LYNN
Middle Name:MARY
Last Name:LIBBY
Suffix:
Gender:F
Credentials:EDS,LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 SUNRISE AVE
Mailing Address - Street 2:
Mailing Address - City:HOPEWELL
Mailing Address - State:NJ
Mailing Address - Zip Code:08525-1316
Mailing Address - Country:US
Mailing Address - Phone:609-333-8588
Mailing Address - Fax:
Practice Address - Street 1:2 TREE FARM RD
Practice Address - Street 2:SUITE 210
Practice Address - City:PENNINGTON
Practice Address - State:NJ
Practice Address - Zip Code:08534-1435
Practice Address - Country:US
Practice Address - Phone:609-333-8588
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-13
Last Update Date:2007-09-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00038500101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional