Provider Demographics
NPI:1356360846
Name:LIEBMAN, DALE N (LCSW-C)
Entity type:Individual
Prefix:MS
First Name:DALE
Middle Name:N
Last Name:LIEBMAN
Suffix:
Gender:F
Credentials:LCSW-C
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3704 BIRCHMERE CT
Mailing Address - Street 2:
Mailing Address - City:OWINGS MILLS
Mailing Address - State:MD
Mailing Address - Zip Code:21117-1256
Mailing Address - Country:US
Mailing Address - Phone:410-356-3056
Mailing Address - Fax:410-653-5215
Practice Address - Street 1:104 CHURCH LN
Practice Address - Street 2:STE.206
Practice Address - City:PIKESVILLE
Practice Address - State:MD
Practice Address - Zip Code:21208-3786
Practice Address - Country:US
Practice Address - Phone:410-484-7024
Practice Address - Fax:410-653-5215
Is Sole Proprietor?:Yes
Enumeration Date:2006-07-18
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD027571041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
MDQ233Medicare ID - Type Unspecified