Provider Demographics
NPI:1528419397
Name:LIBERT, JUDITH W (LCSW-C)
Entity Type:Individual
Prefix:
First Name:JUDITH
Middle Name:W
Last Name:LIBERT
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:856 COLLEGE PKWY
Mailing Address - Street 2:APT T2
Mailing Address - City:ROCKVILLE
Mailing Address - State:MD
Mailing Address - Zip Code:20850-1935
Mailing Address - Country:US
Mailing Address - Phone:240-449-3094
Mailing Address - Fax:240-489-4415
Practice Address - Street 1:10215 FERNWOOD RD
Practice Address - Street 2:SUITE 630
Practice Address - City:BETHESDA
Practice Address - State:MD
Practice Address - Zip Code:20817-1106
Practice Address - Country:US
Practice Address - Phone:240-449-3094
Practice Address - Fax:240-489-4415
Is Sole Proprietor?:Yes
Enumeration Date:2016-06-23
Last Update Date:2016-06-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD112891041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical