Provider Demographics
NPI:1972639227
Name:LIBRIZZI, WILLIAM (PSYD)
Entity Type:Individual
Prefix:
First Name:WILLIAM
Middle Name:
Last Name:LIBRIZZI
Suffix:
Gender:M
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:310 ATLANTIC AVE
Mailing Address - Street 2:
Mailing Address - City:SPRING LAKE
Mailing Address - State:NJ
Mailing Address - Zip Code:07762-1121
Mailing Address - Country:US
Mailing Address - Phone:732-449-4363
Mailing Address - Fax:
Practice Address - Street 1:700 HIGHWAY 71
Practice Address - Street 2:
Practice Address - City:SEA GIRT
Practice Address - State:NJ
Practice Address - Zip Code:08750-2805
Practice Address - Country:US
Practice Address - Phone:732-449-4479
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-23
Last Update Date:2007-10-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJPC450101Y00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor