Provider Demographics
NPI:1447412531
Name:LIBANSKY, ILONA ELISABETH (PHD, LMFT, CAC)
Entity Type:Individual
Prefix:DR
First Name:ILONA
Middle Name:ELISABETH
Last Name:LIBANSKY
Suffix:
Gender:F
Credentials:PHD, LMFT, CAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2621 NE 52ND ST
Mailing Address - Street 2:
Mailing Address - City:LIGHTHOUSE POINT
Mailing Address - State:FL
Mailing Address - Zip Code:33064-7051
Mailing Address - Country:US
Mailing Address - Phone:954-829-5080
Mailing Address - Fax:954-571-7734
Practice Address - Street 1:7880 N UNIVERSITY DR
Practice Address - Street 2:SUITE 202
Practice Address - City:TAMARAC
Practice Address - State:FL
Practice Address - Zip Code:33321-2124
Practice Address - Country:US
Practice Address - Phone:954-829-5080
Practice Address - Fax:954-571-7734
Is Sole Proprietor?:Yes
Enumeration Date:2008-06-30
Last Update Date:2008-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMT 1940106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist