Provider Demographics
NPI:1972216851
Name:MACIP, LIBY DE LA FUENTE (LPC)
Entity type:Individual
Prefix:MRS
First Name:LIBY
Middle Name:DE LA FUENTE
Last Name:MACIP
Suffix:
Gender:F
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7112 ASHER ST
Mailing Address - Street 2:
Mailing Address - City:METAIRIE
Mailing Address - State:LA
Mailing Address - Zip Code:70003-3164
Mailing Address - Country:US
Mailing Address - Phone:504-432-4669
Mailing Address - Fax:
Practice Address - Street 1:3005 HARVARD AVE STE 201
Practice Address - Street 2:
Practice Address - City:METAIRIE
Practice Address - State:LA
Practice Address - Zip Code:70006-6401
Practice Address - Country:US
Practice Address - Phone:504-285-4536
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-01-05
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
171M00000X
LA101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator