Provider Demographics
NPI:1780304279
Name:LIEB, BRITTNEY CLAIRE (LMSW)
Entity type:Individual
Prefix:
First Name:BRITTNEY
Middle Name:CLAIRE
Last Name:LIEB
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1313 NW 92ND ST
Mailing Address - Street 2:
Mailing Address - City:CLIVE
Mailing Address - State:IA
Mailing Address - Zip Code:50325-6275
Mailing Address - Country:US
Mailing Address - Phone:563-210-7729
Mailing Address - Fax:
Practice Address - Street 1:9550 WHITE OAK LN STE 200
Practice Address - Street 2:
Practice Address - City:JOHNSTON
Practice Address - State:IA
Practice Address - Zip Code:50131-2267
Practice Address - Country:US
Practice Address - Phone:515-259-8110
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-09-02
Last Update Date:2022-09-02
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IA115132104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker