MEDICARE: BETSY MAE LIEBERMAN MFT

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	106H00000X	Marriage & Family Therapist

General Provider Information

NPI Number	:	1861540478
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	BETSY MAE LIEBERMAN MFT

Provider Business Mailing Address
First Line	:	3405 SACRAMENTO ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94118-1913
Country	:	US
Telephone Number	:	415-771-7372
Fax Number	:	408-972-3242

Provider Business Practice Location Address
First Line	:	3405 SACRAMENTO ST
Second Line	:
City	:	SAN FRANCISCO
State	:	CA
Zip	:	94118-1913
Country	:	US
Telephone Number	:	415-771-7372
Fax Number	:	408-972-3242

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

Provider Enumeration Date	:	01/08/2007
Last Update Date	:	02/11/2022

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