| Mary Liebermann, Inc. | |
|
1307 Portland Ave Orlando FL 32803-2620 | |
| (407) 719-7749 | |
| Not Available |
| Full Name | Mary Liebermann, Inc. |
|---|---|
| Speciality | Social Worker |
| Location | 1307 Portland Ave, Orlando, Florida |
| Authorized Official Name and Position | Mary Liebermann (PRESIDENT/PSYCHOTHERAPIST) |
| Authorized Official Contact | 3213067830 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Mary Liebermann, Inc. 1307 Portland Ave Orlando FL 32803-2620 Ph: (407) 719-7749 | Mary Liebermann, Inc. 1307 Portland Ave Orlando FL 32803-2620 Ph: (407) 719-7749 |
| NPI Number | 1164721684 |
|---|---|
| Provider Enumeration Date | 03/23/2011 |
| Last Update Date | 03/24/2023 |
| Certification Date | 03/24/2023 |
| Medicare PECOS PAC ID | 4082897277 |
|---|---|
| Medicare Enrollment ID | O20110325000190 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164721684 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | SW3109 (Florida) | Primary |
| Provider Name | Mary Liebermann |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1285826602 PECOS PAC ID: 7416130604 Enrollment ID: I20110325000260 |
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