Healthcare Provider Details

I. General information

NPI: 1629511274
Provider Name (Legal Business Name): REBECCA JANE LIEBMANN-SMITH LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 11/30/2016
Last Update Date: 11/30/2016
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

115 W 27TH ST 4TH FLOOR
NEW YORK NY
10001-6217
US

IV. Provider business mailing address

115 W 27TH ST 4TH FLOOR
NEW YORK NY
10001-6217
US

V. Phone/Fax

Practice location:
  • Phone: 212-627-8181
  • Fax:
Mailing address:
  • Phone: 212-627-8181
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number098199
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: