Provider Demographics
NPI:1184280414
Name:HAAG, ELIZABETH (LIBBY) ANN (PLMHP)
Entity type:Individual
Prefix:
First Name:ELIZABETH (LIBBY)
Middle Name:ANN
Last Name:HAAG
Suffix:
Gender:F
Credentials:PLMHP
Other - Prefix:
Other - First Name:ELIZABETH (LIBBY)
Other - Middle Name:ANN
Other - Last Name:HAAG
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2002 CENTRAL AVE
Mailing Address - Street 2:
Mailing Address - City:KEARNEY
Mailing Address - State:NE
Mailing Address - Zip Code:68847-5302
Mailing Address - Country:US
Mailing Address - Phone:308-627-4743
Mailing Address - Fax:308-224-3711
Practice Address - Street 1:2002 CENTRAL AVE
Practice Address - Street 2:
Practice Address - City:KEARNEY
Practice Address - State:NE
Practice Address - Zip Code:68847-5302
Practice Address - Country:US
Practice Address - Phone:308-627-4743
Practice Address - Fax:308-224-3711
Is Sole Proprietor?:No
Enumeration Date:2019-05-13
Last Update Date:2019-05-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NE11839101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health