Healthcare Provider Details

I. General information

NPI: 1902171143
Provider Name (Legal Business Name): PAMELA LIEBER LICSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 03/21/2012
Last Update Date: 11/07/2025
Certification Date: 11/07/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

2120 BLADENSBURG RD NE
WASHINGTON DC
20018-1440
US

IV. Provider business mailing address

2120 BLADENSBURG RD NE
WASHINGTON DC
20018-1440
US

V. Phone/Fax

Practice location:
  • Phone: 202-407-3080
  • Fax:
Mailing address:
  • Phone: 202-407-3080
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberLC50078097
License Number StateDC

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: