Provider Demographics
NPI:1366441214
Name:LIEBER, JILL (LCSWR)
Entity Type:Individual
Prefix:MRS
First Name:JILL
Middle Name:
Last Name:LIEBER
Suffix:
Gender:F
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2430 N FOREST RD STE 140
Mailing Address - Street 2:
Mailing Address - City:GETZVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:14068-1557
Mailing Address - Country:US
Mailing Address - Phone:716-688-5372
Mailing Address - Fax:716-688-5327
Practice Address - Street 1:2430 N FOREST RD STE 140
Practice Address - Street 2:
Practice Address - City:GETZVILLE
Practice Address - State:NY
Practice Address - Zip Code:14068-1557
Practice Address - Country:US
Practice Address - Phone:716-688-5372
Practice Address - Fax:716-688-5327
Is Sole Proprietor?:Yes
Enumeration Date:2005-07-21
Last Update Date:2019-10-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR043130-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY000590012002OtherBLUECROSS BLUESHIELD
NY00026440101OtherUNIVERA HEALTHCARE
NY140936FKOtherPREFERRED CARE
NY257486OtherAPS HEALTHCARE
NY6211738OtherINDEPENDENT HEALTH
NC535524OtherVALUEOPTIONS NYS EMPIRE
NY02442771Medicaid
NYDD6861Medicare ID - Type Unspecified
NY02442771Medicaid