Healthcare Provider Details

I. General information

NPI: 1386888782
Provider Name (Legal Business Name): LIBERTY HERKNESS WETHERILL MA
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 04/29/2009
Last Update Date: 05/19/2026
Certification Date: 05/19/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 CYNWYD DR
CAPE MAY COURT HOUSE NJ
08210-1979
US

IV. Provider business mailing address

9 CYNWYD DR
CAPE MAY COURT HOUSE NJ
08210-1979
US

V. Phone/Fax

Practice location:
  • Phone: 609-554-0926
  • Fax:
Mailing address:
  • Phone: 609-554-0926
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number16LP00020500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: