Healthcare Provider Details

I. General information

NPI: 1558424630
Provider Name (Legal Business Name): ROSALYN LIEBHOBER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: ROSALYN LIEBHOBER LCSW

II. Dates (important events)

Enumeration Date: 12/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

9 ROBINSON TERRACE
CLIFTON NJ
07013-3917
US

IV. Provider business mailing address

9 ROBINSON TERRACE
CLIFTON NJ
07013-3917
US

V. Phone/Fax

Practice location:
  • Phone: 973-471-9692
  • Fax: 973-471-9692
Mailing address:
  • Phone: 973-471-9692
  • Fax: 973-471-9692

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC00153700
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: