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Contact Information

KRAIG LIBSTAG, ED.D.
86 LAKE ST
BURLINGTON, VT05401-5297
 Phone: 802-865-3450
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for KRAIG LIBSTAG · (Male)

NPI Number 1427076660
Status Active
Credentials ED.D.
Entity Individual
Enumeration date 07/17/2006
Last updated 07/08/2007 - About 19 years ago
Sole proprietor 1 No
Identifiers
  • VT License # 0480000541
  • VT Medicaid 1003824
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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