Provider Demographics
NPI:1225122583
Name:LIBERMAN, JOAN S (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:JOAN
Middle Name:S
Last Name:LIBERMAN
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 1:4419 SADDLEWORTH CIR
Mailing Address - Street 2:
Mailing Address - City:ORLANDO
Mailing Address - State:FL
Mailing Address - Zip Code:32826-4122
Mailing Address - Country:US
Mailing Address - Phone:407-810-5423
Mailing Address - Fax:
Practice Address - Street 1:3400 QUADRANGLE BLVD
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32817-1492
Practice Address - Country:US
Practice Address - Phone:407-810-5423
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-03
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW5224101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health