MEDICARE: MRS. JILL LIEBER LCSWR

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	1041C0700X	Clinical Social Worker	R043130-1	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	000590012002	OTHER	NY	BLUECROSS BLUESHIELD
2	00026440101	OTHER	NY	UNIVERA HEALTHCARE
3	140936FK	OTHER	NY	PREFERRED CARE
4	257486	OTHER	NY	APS HEALTHCARE
5	6211738	OTHER	NY	INDEPENDENT HEALTH
6	535524	OTHER	NC	VALUEOPTIONS NYS EMPIRE
7	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1366441214
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MRS. JILL LIEBER LCSWR

Provider Business Mailing Address
First Line	:	2430 N FOREST RD STE 140
Second Line	:
City	:	GETZVILLE
State	:	NY
Zip	:	14068-1557
Country	:	US
Telephone Number	:	716-688-5372
Fax Number	:	716-688-5327

Provider Business Practice Location Address
First Line	:	2430 N FOREST RD STE 140
Second Line	:
City	:	GETZVILLE
State	:	NY
Zip	:	14068-1557
Country	:	US
Telephone Number	:	716-688-5372
Fax Number	:	716-688-5327

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	07/21/2005
Last Update Date	:	10/30/2019

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