Provider Demographics
NPI:1609767359
Name:LORRON, LIBBY SHANNON (MSW, LICSW)
Entity type:Individual
Prefix:
First Name:LIBBY
Middle Name:SHANNON
Last Name:LORRON
Suffix:
Gender:F
Credentials:MSW, LICSW
Other - Prefix:
Other - First Name:LIBBY
Other - Middle Name:
Other - Last Name:LOUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:4240 PARK GLEN RD
Mailing Address - Street 2:
Mailing Address - City:ST LOUIS PARK
Mailing Address - State:MN
Mailing Address - Zip Code:55416-5427
Mailing Address - Country:US
Mailing Address - Phone:612-925-6033
Mailing Address - Fax:612-925-8496
Practice Address - Street 1:14800 GALAXIE AVE STE 305
Practice Address - Street 2:
Practice Address - City:APPLE VALLEY
Practice Address - State:MN
Practice Address - Zip Code:55124-4530
Practice Address - Country:US
Practice Address - Phone:952-432-1484
Practice Address - Fax:952-432-2328
Is Sole Proprietor?:No
Enumeration Date:2025-07-11
Last Update Date:2025-07-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MN273141041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical