Provider Demographics
NPI:1073231817
Name:LYBARGER, ALICEA
Entity Type:Individual
Prefix:
First Name:ALICEA
Middle Name:
Last Name:LYBARGER
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16143 HI LAND CIR
Mailing Address - Street 2:
Mailing Address - City:BRIGHTON
Mailing Address - State:CO
Mailing Address - Zip Code:80602-7515
Mailing Address - Country:US
Mailing Address - Phone:720-427-4625
Mailing Address - Fax:
Practice Address - Street 1:80 GARDEN CTR STE 170
Practice Address - Street 2:
Practice Address - City:BROOMFIELD
Practice Address - State:CO
Practice Address - Zip Code:80020-1790
Practice Address - Country:US
Practice Address - Phone:720-740-2466
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-18
Last Update Date:2022-08-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
COLPC.0018585101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional