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NPI Code Detail

MEDICARE: TESS L LIEBERSOHN MED, LPC

MEDICARE: TESS L LIEBERSOHN MED, LPC
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
1101YP2500XProfessional CounselorPC014654PA

General Provider Information

NPI Number : 1922861178
Entity Type Code : Individual
Provider Name (Legal Business Name) : TESS L LIEBERSOHN MED, LPC
Provider Business Mailing Address
First Line : 1500 CHESTNUT ST SUITE 2
Second Line : PMB 1184
City : PHILADELPHIA
State : PA
Zip : 19102-2700
Country : US
Telephone Number : 215-837-4224
Fax Number :
Provider Business Practice Location Address
First Line : 3641 LANCASTER AVE
Second Line :
City : PHILADELPHIA
State : PA
Zip : 19104-2603
Country : US
Telephone Number : 267-225-5855
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 01/31/2024
Last Update Date : 02/05/2025

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