Provider Demographics
NPI:1457499238
Name:LALIBERTE, JOSEPH JUSTIN (MSW, LICSW)
Entity Type:Individual
Prefix:MR
First Name:JOSEPH
Middle Name:JUSTIN
Last Name:LALIBERTE
Suffix:
Gender:M
Credentials:MSW, LICSW
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Mailing Address - Street 1:184 GREAT RD
Mailing Address - Street 2:SUITE 3
Mailing Address - City:ACTON
Mailing Address - State:MA
Mailing Address - Zip Code:01720-5758
Mailing Address - Country:US
Mailing Address - Phone:866-635-1712
Mailing Address - Fax:978-635-1712
Practice Address - Street 1:47 LIBERTY ST
Practice Address - Street 2:184 GREAT ROAD, SUITE 3
Practice Address - City:ACTON
Practice Address - State:MA
Practice Address - Zip Code:01720-3547
Practice Address - Country:US
Practice Address - Phone:866-635-1712
Practice Address - Fax:978-635-1712
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-02
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
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Provider Licenses
StateLicense IDTaxonomies
MAMA 1000581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MA2135799OtherCIGNA
MA008355OtherHARVARD PILGRIM HEALTHCAR
MA64266851OtherUNITED BEHAVIORAL HEALTH
MAPO1415OtherBCBS