Provider Demographics
NPI:1609068915
Name:LIBERT, DENNIES (LMSW)
Entity Type:Individual
Prefix:
First Name:DENNIES
Middle Name:
Last Name:LIBERT
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11804 204TH ST
Mailing Address - Street 2:
Mailing Address - City:SAINT ALBANS
Mailing Address - State:NY
Mailing Address - Zip Code:11412-3503
Mailing Address - Country:US
Mailing Address - Phone:718-526-1000
Mailing Address - Fax:718-298-8586
Practice Address - Street 1:971 JEROME ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-9252
Practice Address - Country:US
Practice Address - Phone:718-272-3300
Practice Address - Fax:718-927-1801
Is Sole Proprietor?:Yes
Enumeration Date:2007-08-10
Last Update Date:2009-02-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY068848-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker