Provider Demographics
NPI:1467228247
Name:ADELINA LIBERTO, LCSW
Entity Type:Organization
Organization Name:ADELINA LIBERTO, LCSW
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:ADELINA
Authorized Official - Middle Name:
Authorized Official - Last Name:LIBERTO
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:727-469-3220
Mailing Address - Street 1:602 OZONA VILLAGE DR
Mailing Address - Street 2:
Mailing Address - City:PALM HARBOR
Mailing Address - State:FL
Mailing Address - Zip Code:34683-5334
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:2533 PERMIT PL
Practice Address - Street 2:
Practice Address - City:TRINITY
Practice Address - State:FL
Practice Address - Zip Code:34655-4519
Practice Address - Country:US
Practice Address - Phone:727-469-3220
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-01
Last Update Date:2023-12-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health