Provider Demographics
NPI:1235476375
Name:LIEBERMAN, BETH (MSW)
Entity Type:Individual
Prefix:MS
First Name:BETH
Middle Name:
Last Name:LIEBERMAN
Suffix:
Gender:F
Credentials:MSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:108 E CHEYENNE RD STE 209
Mailing Address - Street 2:
Mailing Address - City:COLORADO SPRINGS
Mailing Address - State:CO
Mailing Address - Zip Code:80906-2535
Mailing Address - Country:US
Mailing Address - Phone:719-444-8550
Mailing Address - Fax:719-444-8551
Practice Address - Street 1:108 E CHEYENNE RD STE 209
Practice Address - Street 2:
Practice Address - City:COLORADO SPRINGS
Practice Address - State:CO
Practice Address - Zip Code:80906-2535
Practice Address - Country:US
Practice Address - Phone:719-444-8550
Practice Address - Fax:719-444-8551
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-09
Last Update Date:2013-01-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CO983012104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker