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General NPI Number Information
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NPI Number | 1912270372
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Entity Type | Organization
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Legal Business Name | GLIEBERMAN, L.M.F.T., P.C.
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Dates
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Enumeration Date | 02/16/2012
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Last Update Date | 02/16/2012
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Provider Practice Location Address
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Address Line | 6946 N CALIFORNIA AVE
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City | CHICAGO
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State | IL
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Zip | 60645-3016
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Country | US
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Telephone | 847-682-3210
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Fax |
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Provider Business Mailing Address
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Address Line | 2954 W ARTHUR AVE APT 3W
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City | CHICAGO
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State | IL
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Zip | 60645-4284
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Country | US
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Telephone | 847-682-3210
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | BRADLEY GLIEBERMAN
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Credential | L.M.F.T.
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Telephone | 847-682-3210
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 261QM0801X
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Taxonomy Name | Mental Health Clinic/Center (Including Community Mental Health Center)
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License Number |
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License Number State |
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