Provider Demographics
NPI:1184249260
Name:ANNE LIBLICH LCSW PC
Entity type:Organization
Organization Name:ANNE LIBLICH LCSW PC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ANNE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIBLICH
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:516-302-7719
Mailing Address - Street 1:107 NORTHERN BLVD STE 300
Mailing Address - Street 2:
Mailing Address - City:GREAT NECK
Mailing Address - State:NY
Mailing Address - Zip Code:11021-4309
Mailing Address - Country:US
Mailing Address - Phone:516-472-7559
Mailing Address - Fax:
Practice Address - Street 1:107 NORTHERN BLVD STE 300
Practice Address - Street 2:
Practice Address - City:GREAT NECK
Practice Address - State:NY
Practice Address - Zip Code:11021-4309
Practice Address - Country:US
Practice Address - Phone:516-472-7559
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-06-14
Last Update Date:2020-06-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health