MEDICARE: HOPE LIBBY LCPC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YP2500X	Professional Counselor
2	101YP2500X	Professional Counselor	CC3362	ME
3	101YM0800X	Mental Health Counselor	CC3362	ME

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000588895	OTHER	VT	BCBS

General Provider Information

NPI Number	:	1700966108
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	HOPE LIBBY LCPC

Provider Business Mailing Address
First Line	:	899 RIVERSIDE ST
Second Line	:
City	:	PORTLAND
State	:	ME
Zip	:	04103-1070
Country	:	US
Telephone Number	:	207-233-8516
Fax Number	:

Provider Business Practice Location Address
First Line	:	557 POST RD
Second Line	:
City	:	BOWDOINHAM
State	:	ME
Zip	:	04008-6002
Country	:	US
Telephone Number	:	207-992-7833
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/17/2006
Last Update Date	:	06/13/2025

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Directions to “ HOPE LIBBY LCPC” Practice Location

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