Provider Demographics
NPI:1003967043
Name:LIEBERMAN, ANNE R (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:R
Last Name:LIEBERMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:400 CANTERBURY LN
Mailing Address - Street 2:
Mailing Address - City:WYCKOFF
Mailing Address - State:NJ
Mailing Address - Zip Code:07481-2304
Mailing Address - Country:US
Mailing Address - Phone:201-891-5805
Mailing Address - Fax:201-426-0086
Practice Address - Street 1:777 TERRACE AVE
Practice Address - Street 2:ADVISORS CAPITAL MANAGEMENT
Practice Address - City:HASBROUCK HEIGHTS
Practice Address - State:NJ
Practice Address - Zip Code:07604-3110
Practice Address - Country:US
Practice Address - Phone:201-315-2399
Practice Address - Fax:201-426-0086
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-16
Last Update Date:2011-07-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSC000425001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJ644136CV9Medicare ID - Type Unspecified