Provider Demographics
NPI:1851465876
Name:LEIBOWITZ, JANET J (PSYD)
Entity Type:Individual
Prefix:DR
First Name:JANET
Middle Name:J
Last Name:LEIBOWITZ
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:DR
Other - First Name:JANET
Other - Middle Name:J
Other - Last Name:LIPMAN
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:PSYD
Mailing Address - Street 1:345 NEPONSET ST STE 6
Mailing Address - Street 2:
Mailing Address - City:CANTON
Mailing Address - State:MA
Mailing Address - Zip Code:02021-1988
Mailing Address - Country:US
Mailing Address - Phone:781-258-3587
Mailing Address - Fax:781-821-1234
Practice Address - Street 1:345 NEPONSET ST
Practice Address - Street 2:
Practice Address - City:CANTON
Practice Address - State:MA
Practice Address - Zip Code:02021-1940
Practice Address - Country:US
Practice Address - Phone:781-828-1222
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-11-20
Last Update Date:2020-03-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CAPSY20569103TC0700X
MA8695103TC0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical