Active NPI
Tracey Libby, MA
- Mental Health Counselor
- Andover, MA
National Provider Identifier
1598710410
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 6167
- Practice address
- 2 Dundee Park
Suite 303a
Andover, MA 01810 - Phone
- (978) 475-6950
- NPI assigned
- May 23, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 6167 | MA | Primary |
Addresses
Primary practice location
2 Dundee Park
Suite 303a
Andover, MA 01810
Mailing address
2 Dundee Park
Suite 303a
Andover, MA 01810
Phone (978) 475-6950
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 4, 2024 through Dec 4, 2026
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6167 | MA | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1148342400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1386201600000",
"number": "1598710410",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2 DUNDEE PARK",
"address_2": "SUITE 303A",
"city": "ANDOVER",
"state": "MA",
"postal_code": "01810",
"telephone_number": "978-475-6950"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "2 DUNDEE PARK",
"address_2": "SUITE 303A",
"city": "ANDOVER",
"state": "MA",
"postal_code": "01810",
"telephone_number": "978-475-6950"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIBBY",
"first_name": "TRACEY",
"name_prefix": "Miss",
"credential": "MA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-05-23",
"last_updated": "2013-12-05",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "MA",
"license": "6167",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Andover, MA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 5, 2013; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.