Provider Demographics
NPI:1700966108
Name:LIBBY, HOPE (LCPC/ PSYCH EXAMINER)
Entity Type:Individual
Prefix:
First Name:HOPE
Middle Name:
Last Name:LIBBY
Suffix:
Gender:F
Credentials:LCPC/ PSYCH EXAMINER
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:899 RIVERSIDE ST
Mailing Address - Street 2:
Mailing Address - City:PORTLAND
Mailing Address - State:ME
Mailing Address - Zip Code:04103-1070
Mailing Address - Country:US
Mailing Address - Phone:207-233-8516
Mailing Address - Fax:
Practice Address - Street 1:22 WEYMOUTH ST
Practice Address - Street 2:
Practice Address - City:RICHMOND
Practice Address - State:ME
Practice Address - Zip Code:04357-1324
Practice Address - Country:US
Practice Address - Phone:207-449-1241
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-17
Last Update Date:2009-09-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MECC3362101YM0800X
MEPE1279103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No103T00000XBehavioral Health & Social Service ProvidersPsychologist
Provider Identifiers
StateIdentifier IDID TypeIssuer
VT1009050Medicaid
VT000588895OtherBCBS