Provider Demographics
NPI:1568619740
Name:LIBO, FELICIA (MA LPC)
Entity Type:Individual
Prefix:
First Name:FELICIA
Middle Name:
Last Name:LIBO
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:861 E 6TH AVE
Mailing Address - Street 2:861 EAST SIXTH AVENUE
Mailing Address - City:DURANGO
Mailing Address - State:CO
Mailing Address - Zip Code:81301-5510
Mailing Address - Country:US
Mailing Address - Phone:970-759-2678
Mailing Address - Fax:
Practice Address - Street 1:861 E 6TH AVE
Practice Address - Street 2:861 EAST SIXTH AVENUE
Practice Address - City:DURANGO
Practice Address - State:CO
Practice Address - Zip Code:81301-5510
Practice Address - Country:US
Practice Address - Phone:970-759-2678
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-08-19
Last Update Date:2011-10-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO3538101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional