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General NPI Number Information
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NPI Number | 1528419397
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Entity Type | Individual
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Provider Name | JUDITH W LIBERT LCSW-C
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Gender | Female
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Dates
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Enumeration Date | 06/23/2016
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Last Update Date | 06/23/2016
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Provider Practice Location Address
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Address Line | 10215 FERNWOOD RD SUITE 630
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City | BETHESDA
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State | MD
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Zip | 20817-1106
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Country | US
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Telephone | 240-449-3094
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Fax | 240-489-4415
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Provider Business Mailing Address
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Address Line | 856 COLLEGE PKWY APT T2
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City | ROCKVILLE
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State | MD
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Zip | 20850-1935
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Country | US
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Telephone | 240-449-3094
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Fax | 240-489-4415
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 11289
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License Number State | MD
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