Libbey, Antiqua Lisha

Libbey, Antiqua Lisha is an individual health care provider with primary practice located at 4821 S Outrigger Dr. , Wasilla AK 99687. She recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Mental Health. Behavioral Health & Social Service Providers / Mental Health is her primary health care specialty. Libbey, Antiqua Lisha can be contacted via phone (907) 354-4345.

Contact Information

Primary practice address
4821 S Outrigger Dr. Wasilla AK 99687
Phone: (907) 354-4345
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X Alaska
Behavioral Health & Social Service Providers / Mental Health 101YM0800X Alaska

Profile Details

NPI number 1619531217
LBN Legal business name Libbey, Antiqua Lisha
Credentials Master of Arts (MA)
Entity Individual
Sole proprietor 1 No
Enumeration date Apr 29th, 2019
Last updated Jun 13th, 2019 - about 7 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

Request for update

Identifiers

StateTypeNumberIssuer
All States NPI 1619531217 NPPES
Alaska MEDICAID $$$$$$$$$

Popular Providers