Provider Demographics
NPI:1386640555
Name:LIBRIZZI, JOSEPH J (LCSW)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:J
Last Name:LIBRIZZI
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:808 MATHEWS ST
Mailing Address - Street 2:
Mailing Address - City:FORT COLLINS
Mailing Address - State:CO
Mailing Address - Zip Code:80524-3315
Mailing Address - Country:US
Mailing Address - Phone:970-492-5309
Mailing Address - Fax:
Practice Address - Street 1:808 MATHEWS ST
Practice Address - Street 2:
Practice Address - City:FORT COLLINS
Practice Address - State:CO
Practice Address - Zip Code:80524-3315
Practice Address - Country:US
Practice Address - Phone:970-492-5309
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2005-06-22
Last Update Date:2015-07-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO15191041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY137672OtherVALUE OPTIONS NUMBER
CO298811OtherMEDICARE PROVIDER NUMBER
CO88589528Medicaid
CO298811Medicare PIN
NY137672OtherVALUE OPTIONS NUMBER