Provider Demographics
NPI:1437360070
Name:YEHUDA LIEBERMAN
Entity Type:Organization
Organization Name:YEHUDA LIEBERMAN
Other - Org Name:MIDWOOD CONSULTING
Other - Org Type:Doing Business As
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:YEHUDA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIEBERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:516-218-4200
Mailing Address - Street 1:833 NAPOLEON ST
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-2317
Mailing Address - Country:US
Mailing Address - Phone:516-218-4200
Mailing Address - Fax:
Practice Address - Street 1:833 NAPOLEON ST
Practice Address - Street 2:
Practice Address - City:WOODMERE
Practice Address - State:NY
Practice Address - Zip Code:11598-2317
Practice Address - Country:US
Practice Address - Phone:516-218-4200
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-05-25
Last Update Date:2022-12-12
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0564731041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY02536414Medicaid
NYS58613Medicare UPIN
NY02536414Medicaid