Healthcare Provider Details

I. General information

NPI: 1407136203
Provider Name (Legal Business Name): SHULAMIS Y LIEBER LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/24/2011
Last Update Date: 09/21/2015
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

16 E 16TH ST
NEW YORK NY
10003-3105
US

IV. Provider business mailing address

279 MAIN ST SUITE 204
NEW PALTZ NY
12561-1623
US

V. Phone/Fax

Practice location:
  • Phone: 212-924-7744
  • Fax: 212-691-2786
Mailing address:
  • Phone: 845-255-3046
  • Fax: 845-255-0236

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number083064
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: