Diana Liebner, ARNP

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

License

AP60542068 Issued in WA

Practice address

3857 Martin Way E
Olympia, WA 98506-5268

Phone

(360) 704-7170

NPI assigned

Jun 19, 2015

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Eligible to order & refer

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

Green means eligible to order or refer.

Opted out of Medicare

Yes, effective Apr 1, 2019 through Apr 1, 2027

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

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

• Behavioral Health Resources

  • Community/Behavioral Health Agency
  • Tumwater, WA
  • NPI 1396820106
  NPD (past)

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

{
    "created_epoch": "1434672000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1434672000000",
    "number": "1124400783",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5308 58TH ST NW",
            "city": "GIG HARBOR",
            "state": "WA",
            "postal_code": "983357329",
            "telephone_number": "949-903-9647"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3857 MARTIN WAY E",
            "city": "OLYMPIA",
            "state": "WA",
            "postal_code": "985065268",
            "telephone_number": "360-704-7170"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBNER",
        "first_name": "DIANA",
        "credential": "ARNP",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2015-06-19",
        "last_updated": "2015-06-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": "WA",
            "license": "AP60542068",
            "primary": true
        },
        {
            "code": "364SP0810X",
            "taxonomy_group": "",
            "desc": "Clinical Nurse Specialist, Psychiatric/Mental Health, Child & Family",
            "state": "WA",
            "license": "RN60273666",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Zhongzeng Li, M.D.
• Katherine Danielle Liam, RN.RN.61262567.MSL
• Chia Wei Liao, PHARM.D.
• Romeo Libiran
• Riley Brydan Liddell
• Katrina Rachele Liebrecht
• Life Therapeutic Works LLC
• Tamara Light, SUDP
• Kimberlie Lilley Aggerrson
• Lillie McCatty, LMHC

• Psychiatric/Mental Health Nurse Practitioner in Olympia, WA
• Providers in Olympia, WA by specialty
• Psychiatric/Mental Health Nurse Practitioner in Washington

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 19, 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; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.