Provider Demographics
NPI:1548393077
Name:GLIEBERMAN, BRADLEY (LMFT, MSMFT)
Entity Type:Individual
Prefix:
First Name:BRADLEY
Middle Name:
Last Name:GLIEBERMAN
Suffix:
Gender:M
Credentials:LMFT, MSMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:6946 N CALIFORNIA AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60645-3016
Mailing Address - Country:US
Mailing Address - Phone:847-682-3210
Mailing Address - Fax:
Practice Address - Street 1:6946 N CALIFORNIA AVE
Practice Address - Street 2:
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60645-3016
Practice Address - Country:US
Practice Address - Phone:847-682-3210
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-03-13
Last Update Date:2009-12-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL166.000766106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist