Provider Demographics
NPI:1902171143
Name:LIEBER, PAMELA THERESA (LICSW)
Entity Type:Individual
Prefix:MS
First Name:PAMELA
Middle Name:THERESA
Last Name:LIEBER
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:119 D ST SE
Mailing Address - Street 2:APT 5
Mailing Address - City:WASHINGTON
Mailing Address - State:DC
Mailing Address - Zip Code:20003-1820
Mailing Address - Country:US
Mailing Address - Phone:202-544-9439
Mailing Address - Fax:
Practice Address - Street 1:119 D ST SE
Practice Address - Street 2:APT 5
Practice Address - City:WASHINGTON
Practice Address - State:DC
Practice Address - Zip Code:20003-1820
Practice Address - Country:US
Practice Address - Phone:202-544-9439
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2012-03-21
Last Update Date:2012-03-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
DCLC500780971041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical