Provider Demographics
NPI:1235176199
Name:LIEBERMAN, ANAT GRUNBERG (LCSW)
Entity Type:Individual
Prefix:
First Name:ANAT
Middle Name:GRUNBERG
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 1:383 NE 194TH TER
Mailing Address - Street 2:
Mailing Address - City:MIAMI
Mailing Address - State:FL
Mailing Address - Zip Code:33179-3995
Mailing Address - Country:US
Mailing Address - Phone:786-417-2492
Mailing Address - Fax:786-513-8276
Practice Address - Street 1:2875 NE 191ST ST STE 552
Practice Address - Street 2:
Practice Address - City:AVENTURA
Practice Address - State:FL
Practice Address - Zip Code:33180-2801
Practice Address - Country:US
Practice Address - Phone:786-417-2492
Practice Address - Fax:786-513-8276
Is Sole Proprietor?:No
Enumeration Date:2006-06-01
Last Update Date:2019-12-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW40131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
26682Medicare ID - Type Unspecified