Healthcare Provider Details

I. General information

NPI: 1366441214
Provider Name (Legal Business Name): JILL LIEBER LCSWR
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/21/2005
Last Update Date: 08/04/2026
Certification Date: 08/04/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4955 N BAILEY AVE STE 205
AMHERST NY
14226-1206
US

IV. Provider business mailing address

4955 N BAILEY AVE STE 205
AMHERST NY
14226-1206
US

V. Phone/Fax

Practice location:
  • Phone: 716-866-4688
  • Fax: 716-428-5694
Mailing address:
  • Phone: 716-866-4688
  • Fax: 716-428-5694

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR043130-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: