Kenneth B Liberty, PH.D.

Primary specialty

Clinical PsychologistTaxonomy code 103TC0700X

License

PS1359 Issued in ME

Practice address

175 W Broadway
Lincoln, ME 04457-4000

Phone

(207) 794-6700

NPI assigned

Oct 19, 2012

Last updated

Feb 26, 2015By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in ME

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Psychologist

Education

Other, 2002

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Northeast Occupational Exchange IncGroup PAC ID 5092709345, 4 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

Locations

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.

• Northeast Occupational Exchange, Inc

  • Psychologist
  • Bangor, ME
  • NPI 1427002138
  Medicare reassignment Care Compare group
• Sweetser

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Saco, ME
  • NPI 1538122445
  Medicare reassignment NPD

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

{
    "created_epoch": "1350604800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1424908800000",
    "number": "1124371778",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 W BROADWAY",
            "city": "LINCOLN",
            "state": "ME",
            "postal_code": "044574000",
            "telephone_number": "207-794-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 W BROADWAY",
            "city": "LINCOLN",
            "state": "ME",
            "postal_code": "044574000",
            "telephone_number": "207-794-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBERTY",
        "first_name": "KENNETH",
        "middle_name": "B",
        "name_prefix": "Dr.",
        "credential": "PH.D.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2012-10-19",
        "last_updated": "2015-02-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "ME",
            "license": "PS1359",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "ANTHEM BLUE CROSS",
            "identifier": "103T00000X",
            "state": "ME"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Martine Legassey, DPT
• Darlene Marie Leisentritt, RPH
• Kara-Beth Levesque, LCPC
• Libby Family Dentistry
• Durwin Yang Libby, DMD
• Susan Ruth Lifer, PT
• Limitless Therapy & Wellness PLLC
• Lincoln Dental, PLLC (Lincoln Dental Associates)
• Lincoln Lakes Medical Supply, LLC
• Lincoln Smiles Dentistry, LLC (Lincoln Smiles Dentistry)

• Clinical Psychologist in Lincoln, ME
• Providers in Lincoln, ME by specialty
• Clinical Psychologist in Maine

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 26, 2015; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.