Provider Demographics
NPI:1043097488
Name:MARIYA LIBMAN LICENSED CLINICAL SOCIAL WORKER INC
Entity Type:Organization
Organization Name:MARIYA LIBMAN LICENSED CLINICAL SOCIAL WORKER INC
Other - Org Name:SYMPHONY THERAPY
Other - Org Type:Doing Business As
Authorized Official - Title/Position:MANAGEMENT
Authorized Official - Prefix:
Authorized Official - First Name:DMITRIY
Authorized Official - Middle Name:
Authorized Official - Last Name:GLIZER
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:323-841-4440
Mailing Address - Street 1:4804 LAUREL CANYON BLVD # 329
Mailing Address - Street 2:
Mailing Address - City:VALLEY VILLAGE
Mailing Address - State:CA
Mailing Address - Zip Code:91607-3717
Mailing Address - Country:US
Mailing Address - Phone:323-841-4440
Mailing Address - Fax:
Practice Address - Street 1:4804 LAUREL CANYON BLVD STE 329
Practice Address - Street 2:
Practice Address - City:VALLEY VILLAGE
Practice Address - State:CA
Practice Address - Zip Code:91607-3717
Practice Address - Country:US
Practice Address - Phone:323-841-4440
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-09-11
Last Update Date:2023-12-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health