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General NPI Number Information
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NPI Number | 1710868237
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Entity Type | Organization
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Legal Business Name | LIBERTY SPRINGS PSYCHIATRY AND THERAPY
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Dates
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Enumeration Date | 09/10/2025
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Last Update Date | 02/19/2026
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Provider Practice Location Address
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Address Line | 1215 CORPORATE CIR SW STE 200
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City | ROANOKE
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State | VA
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Zip | 24018-1400
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Country | US
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Telephone | 727-504-7073
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Fax |
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Provider Business Mailing Address
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Address Line | 4424 WORTHINGTON CIR
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City | PALM HARBOR
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State | FL
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Zip | 34685-1158
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Country | US
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Telephone | 727-504-7073
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | PATRICK E HICKEY
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Credential | PMHNP
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Telephone | 727-504-7073
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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Taxonomy #2
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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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