MEDICARE: SAUL NEIL LIEBERMAN PH.D.

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	103T00000X	Psychologist	01696	MD
2	103TB0200X	Cognitive & Behavioral Psychologist	01696	MD
3	103TC0700X	Clinical Psychologist	01696	MD
4	103TC2200X	Clinical Child & Adolescent Psychologist	01696	MD
5	103TM1800X	Intellectual & Developmental Disabilities Psychologist	01696	MD

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	45614	OTHER	MD	MDIPA - COLUMBIA
2	40157202	OTHER	MD	CAREFIRST MD - COLUMBIA
3	35614	OTHER	MD	MAMSI ID
4	36140002	OTHER	MD	CAREFIRST BC - COLUMBIA
5	36230001	OTHER	MD	CAREFIRST DC PLAN

General Provider Information

NPI Number	:	1871686543
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SAUL NEIL LIEBERMAN PH.D.

Provider Business Mailing Address
First Line	:	9225 LONGBRANCH PARKWAY
Second Line	:
City	:	SILVER SPRING
State	:	MD
Zip	:	20901
Country	:	US
Telephone Number	:	301-439-7507
Fax Number	:

Provider Business Practice Location Address
First Line	:	10630 LITTLE PATUXENT PKWY
Second Line	:	STE 212
City	:	COLUMBIA
State	:	MD
Zip	:	21044-3264
Country	:	US
Telephone Number	:	410-740-0333
Fax Number	:	410-740-0332

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

Provider Enumeration Date	:	10/02/2006
Last Update Date	:	09/11/2025

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