Individual provider Active NPI

Devora Lieberman

  • Mental Health Counselor
  • Folsom, CA
National Provider Identifier
1174153936
Registry record updated Apr 28, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
13169 Issued in CA
Practice address
1750 Prairie City Rd Ste 130
Folsom, CA 95630-9597
Phone
(561) 331-1760
NPI assigned
Jan 21, 2020
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 28, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 13169 CA Primary
Mental Health Counselor 101YM0800X MH17716 FL

Addresses

Primary practice location

1750 Prairie City Rd Ste 130
Folsom, CA 95630-9597

Mailing address

1750 Prairie City Rd Ste 130
Folsom, CA 95630-9597
Phone (561) 331-1760

Other practice location 1

3015 Exchange Ct Fl USA
West Palm Beach, FL 33409-4048
Phone (561) 245-0315

Other identifiers 2

IdentifierTypeStateIssuer
MH17716OtherFLPRIVATE PRACTICE
13169OtherCALICENSED PROFESSIONAL CLINICAL COUNSELOR

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)
Not enrolled

State licenses

LicenseStateTypeSpecialty
13169CAMDMental Health Counselor
MH17716FLMDMental Health Counselor

NPI Registry JSON

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

{
    "created_epoch": "1579564800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1777334400000",
    "number": "1174153936",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1750 PRAIRIE CITY RD STE 130",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956309597",
            "telephone_number": "561-331-1760"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1750 PRAIRIE CITY RD STE 130",
            "city": "FOLSOM",
            "state": "CA",
            "postal_code": "956309597",
            "telephone_number": "561-331-1760"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3015 Exchange Ct Fl USA",
            "address_purpose": "LOCATION",
            "city": "West Palm Beach",
            "state": "FL",
            "postal_code": "334094048",
            "country_code": "US",
            "telephone_number": "561-245-0315",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIEBERMAN",
        "first_name": "DEVORA",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2020-01-21",
        "last_updated": "2026-04-28",
        "certification_date": "2026-04-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "CA",
            "license": "13169",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "FL",
            "license": "MH17716",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "PRIVATE PRACTICE",
            "identifier": "MH17716",
            "state": "FL"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LICENSED PROFESSIONAL CLINICAL COUNSELOR",
            "identifier": "13169",
            "state": "CA"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Folsom, CA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 28, 2026; 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.