Provider Demographics
NPI:1780925479
Name:WENDY LEIBOWITZ LCSW-C
Entity type:Organization
Organization Name:WENDY LEIBOWITZ LCSW-C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERPAIST
Authorized Official - Prefix:
Authorized Official - First Name:WENDY
Authorized Official - Middle Name:
Authorized Official - Last Name:OMINKSY
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-C
Authorized Official - Phone:301-404-6141
Mailing Address - Street 1:3152 SAINT FLORENCE TER
Mailing Address - Street 2:
Mailing Address - City:OLNEY
Mailing Address - State:MD
Mailing Address - Zip Code:20832-1632
Mailing Address - Country:US
Mailing Address - Phone:301-404-6141
Mailing Address - Fax:
Practice Address - Street 1:2907 OLNEY SANDY SPRING RD STE A
Practice Address - Street 2:
Practice Address - City:OLNEY
Practice Address - State:MD
Practice Address - Zip Code:20832-3510
Practice Address - Country:US
Practice Address - Phone:301-404-6141
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2013-03-06
Last Update Date:2013-03-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
MD079991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty