Provider Demographics
NPI:1366557282
Name:LIBBY, MELODY DAWN (M ED, LPC)
Entity type:Individual
Prefix:MS
First Name:MELODY
Middle Name:DAWN
Last Name:LIBBY
Suffix:
Gender:F
Credentials:M ED, LPC
Other - Prefix:
Other - First Name:MELODY
Other - Middle Name:DAWN
Other - Last Name:CARMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:5232 92ND ST
Mailing Address - Street 2:
Mailing Address - City:LUBBOCK
Mailing Address - State:TX
Mailing Address - Zip Code:79424-4314
Mailing Address - Country:US
Mailing Address - Phone:254-292-8242
Mailing Address - Fax:
Practice Address - Street 1:5232 92ND ST
Practice Address - Street 2:
Practice Address - City:LUBBOCK
Practice Address - State:TX
Practice Address - Zip Code:79424-4314
Practice Address - Country:US
Practice Address - Phone:254-292-8242
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-20
Last Update Date:2024-02-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
TX18454101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional