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General NPI Number Information
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NPI Number | 1972216851
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Entity Type | Individual
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Provider Name | LIBY DE LA FUENTE MACIP LPC
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Gender | Female
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Dates
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Enumeration Date | 01/05/2023
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Last Update Date | 10/06/2025
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Provider Practice Location Address
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Address Line | 3005 HARVARD AVE STE 201
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City | METAIRIE
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State | LA
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Zip | 70006-6401
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Country | US
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Telephone | 504-285-4536
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Fax |
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Provider Business Mailing Address
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Address Line | 7112 ASHER ST
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City | METAIRIE
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State | LA
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Zip | 70003-3164
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Country | US
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Telephone | 504-432-4669
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State | LA
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Taxonomy #2
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number | LPC9381
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License Number State | LA
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