Provider Demographics
NPI:1023600228
Name:GILIBERTO, JANA (LMHC)
Entity type:Individual
Prefix:
First Name:JANA
Middle Name:
Last Name:GILIBERTO
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1726 COUNTRY CLUB BLVD
Mailing Address - Street 2:
Mailing Address - City:CAPE CORAL
Mailing Address - State:FL
Mailing Address - Zip Code:33990-2305
Mailing Address - Country:US
Mailing Address - Phone:239-297-3889
Mailing Address - Fax:
Practice Address - Street 1:12535 NEW BRITTANY BLVD STE 2821
Practice Address - Street 2:
Practice Address - City:FORT MYERS
Practice Address - State:FL
Practice Address - Zip Code:33907-3625
Practice Address - Country:US
Practice Address - Phone:239-297-3889
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-02-09
Last Update Date:2021-02-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLMH10909101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health