Provider Demographics
NPI:1821412933
Name:LIEBER, CAROL H (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:CAROL
Middle Name:H
Last Name:LIEBER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:11215 CARROLLWOOD DR
Mailing Address - Street 2:
Mailing Address - City:TAMPA
Mailing Address - State:FL
Mailing Address - Zip Code:33618-3701
Mailing Address - Country:US
Mailing Address - Phone:813-956-7586
Mailing Address - Fax:
Practice Address - Street 1:14502 N DALE MABRY HWY
Practice Address - Street 2:SUITE 330
Practice Address - City:TAMPA
Practice Address - State:FL
Practice Address - Zip Code:33618-2075
Practice Address - Country:US
Practice Address - Phone:813-968-9600
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-02-10
Last Update Date:2014-02-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FL114901041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical