Healthcare Provider Details

I. General information

NPI: 1801040167
Provider Name (Legal Business Name): HEIDI E. LIEB-GRANEY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/12/2008
Last Update Date: 08/07/2026
Certification Date: 08/07/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

121 NORTH ST
AUBURN NY
13021-1826
US

IV. Provider business mailing address

7 S LEWIS ST
AUBURN NY
13021-2707
US

V. Phone/Fax

Practice location:
  • Phone: 315-412-3625
  • Fax: 315-252-3074
Mailing address:
  • Phone: 315-412-3625
  • Fax: 315-252-3074

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number083880-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: