MS. CAROL ANN LIBONATI


Address: 810 Light St., Suite 103, Baltimore, MD 21230
Phone: 4109082099

MS. CAROL ANN LIBONATI (NPI# 1437376472) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).

Provider Overview

Nation Provider ID (NPI) 1437376472
Entity Type Individual
Full Name MS. CAROL ANN LIBONATI
Credential APRN
Practice Address 810 Light St.
Suite 103
Baltimore
MD 21230
Mailing Address 3801 Juniper Rd
Baltimore
MD 21218-1828
Practice Telephone 4109082099
Practice Fax Number 4102432507
Mailing Telephone 4102438306
Mailing Fax Number 4102432507
Enumeration Date 2007-04-19
Last Update Date 2007-07-08
Gender Code F
Is Sole Proprietor Y

Taxonomy

Primary Taxonomy Code Classification License Number License State Taxonomy Group
Y 163WP0809X Registered Nurse
Specialization: Psych/Mental Health, Adult
R039456 MD Nursing Service Providers

Other Provider Identifier

State Issuer Identifier Type Code
MD CIGNA 1049727 01
MH AMERICAN PSYCH SYSTEMS PVPB101825 01
MD COMPSYCH 167836 01
MD VALUE OPTIONS 002505 01
MD CAREFIRST FEDERAL EMPLOYE G4640001 01
MD EMPLOYEE HEALTH PLAN 23382 01
MD MULTIPLAN 9079442 01
MD MAGELLAN IP 276313 01
MD CAREFIRST BLUE CROSS BLUE PQ02CA 01
MD MAMSI 364943 01

Office Location

Street Address 810 LIGHT ST.
SUITE 103
City BALTIMORE
State MD
Zip Code 21230

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Taxonomy Information

Taxonomy Code 163WP0809X
Grouping Nursing Service Providers
Classification Registered Nurse
Specialization Psych/Mental Health, Adult

Taxonomy Definition

Definition to come...

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Competitor

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City BALTIMORE
Zip Code 21230

Improve Information

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Dataset Information

Data Provider Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES)
Jurisdiction Medicare & Medicaid

This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.

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