Doctor Name: | PHILLIP CHARLES LIBRIZZI |
NPI Number: | 1013991108 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LMHC |
License Number: | 39001373A |
Business Practice Address: | 645 South Rogers Street Bloomington, IN - 47403 |
Business Phone Number: | 8123391691 |
Business Fax Number: | 8123398109 |
Mailing Address: | 645 South Rogers Street, BLOOMINGTON |
State: | IN |
Postal Code: | 47403 |
Phone Number: | 8123391691 |
Fax Number: | 8123398109 |
NPI Enumeration Date: | 12/01/2005 |
NPI Last Update Date: | 07/08/2007 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YM0800X |
License Number: | 39001373A |
Healthcare Provider Taxonomy: (Secondary) | Y |
State: | IN |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Mental Health |
Taxonomy Definition: |