Healthcare Provider Details

I. General information

NPI: 1063530723
Provider Name (Legal Business Name): CAREN BETH LIEBMAN LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 03/27/2007
Last Update Date: 09/25/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3003 WILLAMETTE ST STE E
EUGENE OR
97405-3295
US

IV. Provider business mailing address

3480 POTTER ST
EUGENE OR
97405-4269
US

V. Phone/Fax

Practice location:
  • Phone: 541-525-2221
  • Fax:
Mailing address:
  • Phone: 541-342-3108
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberL3050
License Number StateOR

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: