Provider Demographics
NPI:1336033133
Name:LALIBERTE, MICHAEL ROGER
Entity type:Individual
Prefix:DR
First Name:MICHAEL
Middle Name:ROGER
Last Name:LALIBERTE
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 JACOB JONES WAY
Mailing Address - Street 2:
Mailing Address - City:WESTBOROUGH
Mailing Address - State:MA
Mailing Address - Zip Code:01581-3633
Mailing Address - Country:US
Mailing Address - Phone:414-931-1565
Mailing Address - Fax:
Practice Address - Street 1:4 JACOB JONES WAY
Practice Address - Street 2:
Practice Address - City:WESTBOROUGH
Practice Address - State:MA
Practice Address - Zip Code:01581-3633
Practice Address - Country:US
Practice Address - Phone:414-931-1565
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-06-05
Last Update Date:2025-06-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health