Provider Demographics
NPI:1922349703
Name:LIBURD, DAVID LEMINGTON SR (LCSW)
Entity Type:Individual
Prefix:MR
First Name:DAVID
Middle Name:LEMINGTON
Last Name:LIBURD
Suffix:SR
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4008 DANESBOROUGH PL
Mailing Address - Street 2:
Mailing Address - City:TALLAHASSEE
Mailing Address - State:FL
Mailing Address - Zip Code:32303-2048
Mailing Address - Country:US
Mailing Address - Phone:850-574-0613
Mailing Address - Fax:
Practice Address - Street 1:535 APPLEYARD DR
Practice Address - Street 2:
Practice Address - City:TALLAHASSEE
Practice Address - State:FL
Practice Address - Zip Code:32304-3801
Practice Address - Country:US
Practice Address - Phone:850-922-3539
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-03-04
Last Update Date:2013-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLSW 100981041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical