Provider Demographics
NPI:1124399175
Name:LIEBER-SUMMERS, LISA J (LSCSW)
Entity Type:Individual
Prefix:MS
First Name:LISA
Middle Name:J
Last Name:LIEBER-SUMMERS
Suffix:
Gender:F
Credentials:LSCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6248 W 155TH ST
Mailing Address - Street 2:
Mailing Address - City:OVERLAND PARK
Mailing Address - State:KS
Mailing Address - Zip Code:66223-3593
Mailing Address - Country:US
Mailing Address - Phone:913-239-8410
Mailing Address - Fax:
Practice Address - Street 1:8000 LEE BLVD
Practice Address - Street 2:
Practice Address - City:LEAWOOD
Practice Address - State:KS
Practice Address - Zip Code:66206-1217
Practice Address - Country:US
Practice Address - Phone:913-381-4992
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-01-23
Last Update Date:2012-03-28
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KS2490101YM0800X
MO2012002892101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health