Provider Demographics
NPI:1417293242
Name:LIEBMAN, JODEE BURKINSHAW (MSW)
Entity Type:Individual
Prefix:MS
First Name:JODEE
Middle Name:BURKINSHAW
Last Name:LIEBMAN
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 1:105 PINK FOX COVE RD
Mailing Address - Street 2:
Mailing Address - City:WEAVERVILLE
Mailing Address - State:NC
Mailing Address - Zip Code:28787-8814
Mailing Address - Country:US
Mailing Address - Phone:828-544-0438
Mailing Address - Fax:
Practice Address - Street 1:959 MERRIMON AVE STE 202
Practice Address - Street 2:
Practice Address - City:ASHEVILLE
Practice Address - State:NC
Practice Address - Zip Code:28804-2353
Practice Address - Country:US
Practice Address - Phone:828-544-0438
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-12-26
Last Update Date:2019-05-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YM0800X
NCC0105961041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health