Individual provider Active NPI

Beverly Liberato

  • Clinical Social Worker
  • Hilo, HI
National Provider Identifier
1093859589
Registry record updated Jul 21, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
LCSW - 3282 Issued in HI
Practice address
37 Kekaulike St
Hilo, HI 96720-2462
Phone
(808) 974-4300
Fax
(808) 974-4310
NPI assigned
Feb 16, 2007
Last updated
Jul 21, 2008By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2008

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X HI
Clinical Social Worker 1041C0700X LCSW - 3282 HI Primary

Addresses

Primary practice location

37 Kekaulike St
Hilo, HI 96720-2462

Mailing address

136 Kinoole St
Hilo, HI 96720-2816
Phone (808) 974-4300

Other identifiers 1

IdentifierTypeStateIssuer
539372-15MedicaidHI

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LCSW - 3282HIMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
State of Hawaii Department of Health Past Accepting new patients
State of Hawaii Department of Health Past Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1171584000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1216598400000",
    "number": "1093859589",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "136 KINOOLE ST",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202816",
            "telephone_number": "808-974-4300",
            "fax_number": "808-974-4310"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "37 KEKAULIKE ST",
            "city": "HILO",
            "state": "HI",
            "postal_code": "967202462",
            "telephone_number": "808-974-4300",
            "fax_number": "808-974-4310"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBERATO",
        "first_name": "BEVERLY",
        "name_prefix": "Mrs.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-02-16",
        "last_updated": "2008-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "HI",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "HI",
            "license": "LCSW - 3282",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "539372-15",
            "state": "HI"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Hilo, HI

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.