Libbey Occupational Therapy Services LLC

Primary specialty

Pediatric Occupational TherapistTaxonomy code 225XP0200X

License

0004073 Issued in CO

Legal business name

LIBBEY OCCUPATIONAL THERAPY SERVICES LLC

Practice address

100 West Arapahoe LN
Suite 12
Boulder, CO 80302

Phone

(720) 308-2565

NPI assigned

Aug 28, 2015

Last updated

Aug 28, 2015By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Nisa Russell Libbey, B.S. OTR/LNPI 1972969624

Title

Occupational Therapist, Owner

Phone

(720) 308-2565

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Nisa Russell Libbey, OTR

  • Occupational Therapist
  • Lafayette, CO
  • NPI 1972969624
  NPD (past) Authorized official

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

{
    "created_epoch": "1440720000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1440720000000",
    "number": "1699142380",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "345 VERNIER AVE",
            "city": "LAFAYETTE",
            "state": "CO",
            "postal_code": "800263128",
            "telephone_number": "720-308-2565"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 WEST ARAPAHOE LN",
            "address_2": "SUITE 12",
            "city": "BOULDER",
            "state": "CO",
            "postal_code": "80302",
            "telephone_number": "720-308-2565"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBBEY OCCUPATIONAL THERAPY SERVICES LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-08-28",
        "last_updated": "2015-08-28",
        "status": "A",
        "authorized_official_last_name": "LIBBEY",
        "authorized_official_first_name": "NISA",
        "authorized_official_middle_name": "RUSSELL",
        "authorized_official_title_or_position": "OCCUPATIONAL THERAPIST, OWNER",
        "authorized_official_telephone_number": "720-308-2565",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "B.S. OTR/L"
    },
    "taxonomies": [
        {
            "code": "225XP0200X",
            "taxonomy_group": "",
            "desc": "Occupational Therapist, Pediatrics",
            "state": "CO",
            "license": "0004073",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Li Chiropractic Healing Arts
• Li Lins Oriental Medical Center, Inc.
• Tao Li-Stein, MD
• Linda M Li, D.C.
• Tiejun Li, L.AC, C.M.T.
• Diana Licalzi, RD, CDCES
• Marcia Lattanzi Licht, MA, LPC
• Beth Anne Lichtenstein, M.A., L.P.C.
• Simone Lichty
• David Lieberman, MFTC

• Pediatric Occupational Therapist in Boulder, CO
• Providers in Boulder, CO by specialty
• Pediatric Occupational Therapist in Colorado

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 28, 2015; 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.