Provider Demographics
NPI:1710859483
Name:LYBRAND, CAITLIN ROSE (LPC)
Entity type:Individual
Prefix:MRS
First Name:CAITLIN
Middle Name:ROSE
Last Name:LYBRAND
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:CAITLIN
Other - Middle Name:ROSE
Other - Last Name:KENNAUGH
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:115 GAURA LN
Mailing Address - Street 2:
Mailing Address - City:SUMMERVILLE
Mailing Address - State:SC
Mailing Address - Zip Code:29483-8446
Mailing Address - Country:US
Mailing Address - Phone:631-252-5003
Mailing Address - Fax:
Practice Address - Street 1:504 W 5TH NORTH ST
Practice Address - Street 2:
Practice Address - City:SUMMERVILLE
Practice Address - State:SC
Practice Address - Zip Code:29483-6105
Practice Address - Country:US
Practice Address - Phone:843-557-2667
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2025-09-22
Last Update Date:2025-09-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
SC11189101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health