Provider Demographics
NPI:1184308868
Name:VALERIE LIEBERT LLC
Entity type:Organization
Organization Name:VALERIE LIEBERT LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/PRESIDENT
Authorized Official - Prefix:
Authorized Official - First Name:VALERIE
Authorized Official - Middle Name:JEAN
Authorized Official - Last Name:LIEBERT
Authorized Official - Suffix:
Authorized Official - Credentials:LPCC
Authorized Official - Phone:419-309-7100
Mailing Address - Street 1:337 W. 2ND STREET
Mailing Address - Street 2:
Mailing Address - City:PERRYSBURG
Mailing Address - State:OH
Mailing Address - Zip Code:43551-1406
Mailing Address - Country:US
Mailing Address - Phone:419-309-7100
Mailing Address - Fax:
Practice Address - Street 1:337 W. 2ND STREET
Practice Address - Street 2:
Practice Address - City:PERRYSBURG
Practice Address - State:OH
Practice Address - Zip Code:43551-1406
Practice Address - Country:US
Practice Address - Phone:419-309-7100
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-06-13
Last Update Date:2023-06-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessionalGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
OH0190462Medicaid