MEDICARE: ERIN LIEBLER LMHC

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	101YM0800X	Mental Health Counselor	007256-1	NY

General Provider Information

NPI Number	:	1942652318
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	ERIN LIEBLER LMHC

Provider Business Mailing Address
First Line	:	19 POWELL ST
Second Line	:
City	:	FARMINGDALE
State	:	NY
Zip	:	11735-4905
Country	:	US
Telephone Number	:	516-828-2775
Fax Number	:

Provider Business Practice Location Address
First Line	:	350 JERICHO TPKE STE 103
Second Line	:
City	:	JERICHO
State	:	NY
Zip	:	11753-1317
Country	:	US
Telephone Number	:	516-828-2775
Fax Number	:

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

Provider Enumeration Date	:	07/08/2016
Last Update Date	:	08/12/2024

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