Provider Demographics
NPI:1770964033
Name:LIBBY, MELISSA A (DSW, LICSW)
Entity type:Individual
Prefix:DR
First Name:MELISSA
Middle Name:A
Last Name:LIBBY
Suffix:
Gender:F
Credentials:DSW, LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:51 TOWLE RD
Mailing Address - Street 2:
Mailing Address - City:CONWAY
Mailing Address - State:NH
Mailing Address - Zip Code:03818-6041
Mailing Address - Country:US
Mailing Address - Phone:603-630-0917
Mailing Address - Fax:
Practice Address - Street 1:3073 WHITE MOUNTAIN HWY
Practice Address - Street 2:
Practice Address - City:NORTH CONWAY
Practice Address - State:NH
Practice Address - Zip Code:03860-7101
Practice Address - Country:US
Practice Address - Phone:603-356-5472
Practice Address - Fax:603-356-9647
Is Sole Proprietor?:No
Enumeration Date:2015-06-12
Last Update Date:2025-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NH50171041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical