Provider Demographics
NPI:1093256281
Name:LIEBMAN, RACHEL KENNEDY (LMHC)
Entity Type:Individual
Prefix:
First Name:RACHEL
Middle Name:KENNEDY
Last Name:LIEBMAN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:33 WYNMOR RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583-7262
Mailing Address - Country:US
Mailing Address - Phone:917-279-8177
Mailing Address - Fax:
Practice Address - Street 1:33 WYNMOR RD
Practice Address - Street 2:
Practice Address - City:SCARSDALE
Practice Address - State:NY
Practice Address - Zip Code:10583-7262
Practice Address - Country:US
Practice Address - Phone:917-279-8177
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-03-20
Last Update Date:2017-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000963-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health