Provider Demographics
NPI:1659240901
Name:LIBRA, MAGGIE MARIE (PLADC)
Entity type:Individual
Prefix:MS
First Name:MAGGIE
Middle Name:MARIE
Last Name:LIBRA
Suffix:
Gender:F
Credentials:PLADC
Other - Prefix:MS
Other - First Name:MAGGIE
Other - Middle Name:MARIE
Other - Last Name:IRONCLOUD
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:PLADC
Mailing Address - Street 1:225 BLUFF ST
Mailing Address - Street 2:
Mailing Address - City:WINNEBAGO
Mailing Address - State:NE
Mailing Address - Zip Code:68071-9703
Mailing Address - Country:US
Mailing Address - Phone:402-878-2480
Mailing Address - Fax:
Practice Address - Street 1:225 BLUFF ST
Practice Address - Street 2:
Practice Address - City:WINNEBAGO
Practice Address - State:NE
Practice Address - Zip Code:68071-9703
Practice Address - Country:US
Practice Address - Phone:402-878-2480
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-11-04
Last Update Date:2025-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NEP-2378101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)