Provider Demographics
NPI:1033781901
Name:KELINGOS, LIBBEE JO (LLPC)
Entity Type:Individual
Prefix:
First Name:LIBBEE
Middle Name:JO
Last Name:KELINGOS
Suffix:
Gender:F
Credentials:LLPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2620 MANOR DR
Mailing Address - Street 2:
Mailing Address - City:MIDLAND
Mailing Address - State:MI
Mailing Address - Zip Code:48640-4440
Mailing Address - Country:US
Mailing Address - Phone:989-948-8381
Mailing Address - Fax:
Practice Address - Street 1:2528 W WACKERLY ST
Practice Address - Street 2:
Practice Address - City:MIDLAND
Practice Address - State:MI
Practice Address - Zip Code:48640-6921
Practice Address - Country:US
Practice Address - Phone:989-832-0191
Practice Address - Fax:989-486-9413
Is Sole Proprietor?:No
Enumeration Date:2021-07-12
Last Update Date:2021-08-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MI6451019493101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional