Carol Ann Libonati, APRN

Primary specialty

Adult Psychiatric/Mental Health Registered NurseTaxonomy code 163WP0809X

License

R039456 Issued in MD

Practice address

810 Light St.
Suite 103
Baltimore, MD 21230

Phone

(410) 908-2099

Fax

(410) 243-2507

NPI assigned

Apr 19, 2007

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Addresses

Other identifiers 10

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Certified Nurse Specialist, Registered Nurse

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• John Burton Driscoll

  dba Bay Area Behavioral Health LLC

  • Clinical Psychologist
  • Severna Park, MD
  • NPI 1396794814
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1176940800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1437376472",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3801 JUNIPER RD",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "212181828",
            "telephone_number": "410-243-8306",
            "fax_number": "410-243-2507"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "810 LIGHT ST.",
            "address_2": "SUITE 103",
            "city": "BALTIMORE",
            "state": "MD",
            "postal_code": "21230",
            "telephone_number": "410-908-2099",
            "fax_number": "410-243-2507"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBONATI",
        "first_name": "CAROL",
        "middle_name": "ANN",
        "name_prefix": "Ms.",
        "credential": "APRN",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-04-19",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "163WP0809X",
            "taxonomy_group": "",
            "desc": "Registered Nurse, Psychiatric/Mental Health, Adult",
            "state": "MD",
            "license": "R039456",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "002505",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MULTIPLAN",
            "identifier": "9079442",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST BLUE CROSS BLUE",
            "identifier": "PQ02CA",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAGELLAN",
            "identifier": "IP 276313",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "COMPSYCH",
            "identifier": "167836",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "MAMSI",
            "identifier": "364943",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AMERICAN PSYCH SYSTEMS",
            "identifier": "PVPB101825",
            "state": "MH"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CIGNA",
            "identifier": "1049727",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "CAREFIRST FEDERAL EMPLOYE",
            "identifier": "G4640001",
            "state": "MD"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "EMPLOYEE HEALTH PLAN",
            "identifier": "23382",
            "state": "MD"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Liberty Medical & Injury Center
• Liberty Medical &Injury Center
• Liberty Medical Services, LLC
• Liberty Nursing Referral Service
• Liberty Pharmacy LLC
• Michael Matthew Librie, LCSW-C
• Isabel Licata
• Carmen Susanne Licavoli, MSN, APRN-BC
• Denise Lichaa, R.D., L.D.N.
• Richard Lichenstein, M.D.

• Adult Psychiatric/Mental Health Registered Nurse in Baltimore, MD
• Providers in Baltimore, MD by specialty
• Adult Psychiatric/Mental Health Registered Nurse in Maryland

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.