Healthcare Provider Details

I. General information

NPI: 1497647093
Provider Name (Legal Business Name): ANDREA ANN LIEBERMAN LMHC
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/17/2025
Last Update Date: 07/17/2025
Certification Date: 07/17/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15055 NW 27TH AVE
OPA LOCKA FL
33054-3365
US

IV. Provider business mailing address

7545 NW 15TH ST
PLANTATION FL
33313-5903
US

V. Phone/Fax

Practice location:
  • Phone: 786-466-2800
  • Fax: 786-466-2847
Mailing address:
  • Phone: 786-466-2800
  • Fax: 786-466-2847

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License NumberMH2416
License Number StateFL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: