Provider Demographics
NPI:1619912706
Name:LIBRETTO, IRENE J (LCSW)
Entity Type:Individual
Prefix:MS
First Name:IRENE
Middle Name:J
Last Name:LIBRETTO
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:80 SUNSET DR
Mailing Address - Street 2:
Mailing Address - City:MARSHALL
Mailing Address - State:NC
Mailing Address - Zip Code:28753-9565
Mailing Address - Country:US
Mailing Address - Phone:516-428-6582
Mailing Address - Fax:
Practice Address - Street 1:80 SUNSET DR
Practice Address - Street 2:
Practice Address - City:MARSHALL
Practice Address - State:NC
Practice Address - Zip Code:28753-9565
Practice Address - Country:US
Practice Address - Phone:516-428-6582
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-06-20
Last Update Date:2010-03-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NCC0053251041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical