Provider Demographics
NPI:1588352330
Name:LIBIDO HEALTH INC.
Entity type:Organization
Organization Name:LIBIDO HEALTH INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:LPC
Authorized Official - Prefix:
Authorized Official - First Name:RUFUS
Authorized Official - Middle Name:TONY
Authorized Official - Last Name:SPANN
Authorized Official - Suffix:
Authorized Official - Credentials:PHD
Authorized Official - Phone:301-442-6158
Mailing Address - Street 1:120 WATERFRONT ST STE 420
Mailing Address - Street 2:
Mailing Address - City:OXON HILL
Mailing Address - State:MD
Mailing Address - Zip Code:20745-1122
Mailing Address - Country:US
Mailing Address - Phone:301-960-8537
Mailing Address - Fax:
Practice Address - Street 1:120 WATERFRONT ST STE 420
Practice Address - Street 2:
Practice Address - City:OXON HILL
Practice Address - State:MD
Practice Address - Zip Code:20745-1122
Practice Address - Country:US
Practice Address - Phone:301-960-8537
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-28
Last Update Date:2023-04-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty