Provider Demographics
NPI:1194738633
Name:LYBARGER, WILLIAM MEREDITH (EDD)
Entity type:Individual
Prefix:MR
First Name:WILLIAM
Middle Name:MEREDITH
Last Name:LYBARGER
Suffix:
Gender:M
Credentials:EDD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2370 YORK RD.
Mailing Address - Street 2:SUITE D4
Mailing Address - City:JAMISON
Mailing Address - State:PA
Mailing Address - Zip Code:18929-1031
Mailing Address - Country:US
Mailing Address - Phone:215-491-9900
Mailing Address - Fax:215-491-9902
Practice Address - Street 1:2370 YORK RD.
Practice Address - Street 2:SUITE D4
Practice Address - City:JAMISON
Practice Address - State:PA
Practice Address - Zip Code:18929-1031
Practice Address - Country:US
Practice Address - Phone:215-968-7600
Practice Address - Fax:215-968-7609
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-15
Last Update Date:2015-01-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS-002588-L103TC1900X
PAPS002588L103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling