MEDICARE: JENNIFER COWING LIEBER LCSW

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	73050885	NY

General Provider Information

NPI Number	:	1609016039
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	JENNIFER COWING LIEBER LCSW

Provider Business Mailing Address
First Line	:	31 E 12TH ST
Second Line	:	SUITE 1E
City	:	NEW YORK
State	:	NY
Zip	:	10003-4623
Country	:	US
Telephone Number	:	646-621-0414
Fax Number	:	212-475-0414

Provider Business Practice Location Address
First Line	:	31 E 12TH ST
Second Line	:	SUITE 1E
City	:	NEW YORK
State	:	NY
Zip	:	10003-4623
Country	:	US
Telephone Number	:	646-621-0414
Fax Number	:	212-475-0414

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

Provider Enumeration Date	:	02/25/2009
Last Update Date	:	02/25/2009

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