Provider Demographics
NPI:1003359852
Name:LIEBERTH, MARIBETH (MA LPC)
Entity Type:Individual
Prefix:
First Name:MARIBETH
Middle Name:
Last Name:LIEBERTH
Suffix:
Gender:F
Credentials:MA LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11558 PEACH GLEN AVE NW
Mailing Address - Street 2:
Mailing Address - City:UNIONTOWN
Mailing Address - State:OH
Mailing Address - Zip Code:44685-8602
Mailing Address - Country:US
Mailing Address - Phone:330-618-4154
Mailing Address - Fax:
Practice Address - Street 1:900 MULL AVE
Practice Address - Street 2:
Practice Address - City:AKRON
Practice Address - State:OH
Practice Address - Zip Code:44313-7502
Practice Address - Country:US
Practice Address - Phone:800-621-5207
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2016-11-28
Last Update Date:2016-11-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OHC0700917101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional