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General NPI Number Information
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NPI Number | 1336787068
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Entity Type | Organization
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Legal Business Name | SOUTH METRO MENTAL HEALTH LLC
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Dates
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Enumeration Date | 12/12/2019
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Last Update Date | 02/24/2020
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Provider Practice Location Address
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Address Line | 7752 ELMWOOD ST
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City | LITTLETON
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State | CO
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Zip | 80125-8828
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Country | US
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Telephone | 303-594-7544
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Fax |
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Provider Business Mailing Address
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Address Line | 7752 ELMWOOD ST
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City | LITTLETON
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State | CO
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Zip | 80125-8828
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Country | US
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Telephone |
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | ANNA MICHELLE LIBBY
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Credential | PMHNP-BC
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Telephone | 303-594-7544
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 363LP0808X
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Taxonomy Name | Psychiatric/Mental Health Nurse Practitioner
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License Number |
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License Number State |
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