Healthcare Provider Details

I. General information

NPI: 1609289222
Provider Name (Legal Business Name): LIEBMAN PSYCHOTHERAPY, PC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/11/2014
Last Update Date: 09/10/2019
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

959 MERRIMON AVE. SUITE 202
ASHEVILLE NC
28804
US

IV. Provider business mailing address

105 PINK FOX COVE ROAD
WEAVERVILLE NC
28787
US

V. Phone/Fax

Practice location:
  • Phone: 828-544-0438
  • Fax:
Mailing address:
  • Phone: 828-544-0438
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberC010618
License Number StateNC
# 2
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MS. JODEE B LIEBMAN
Title or Position: CLINICAL SOCIAL WORK/OWNER
Credential: LCSW
Phone: 828-544-0438