Provider Demographics
NPI:1700144540
Name:LIBLICH, ANNE (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:ANNE
Middle Name:
Last Name:LIBLICH
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:7 JUNIPER HILL RD
Mailing Address - Street 2:
Mailing Address - City:EAST SANDWICH
Mailing Address - State:MA
Mailing Address - Zip Code:02537-1020
Mailing Address - Country:US
Mailing Address - Phone:516-302-7719
Mailing Address - Fax:
Practice Address - Street 1:7 JUNIPER HILL RD
Practice Address - Street 2:
Practice Address - City:EAST SANDWICH
Practice Address - State:MA
Practice Address - Zip Code:02537-1020
Practice Address - Country:US
Practice Address - Phone:516-302-7719
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-30
Last Update Date:2022-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MA1236831041C0700X
NY0840741041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty