Active NPI
Bethany A. Lieberman, PSY.D.
- Clinical Psychologist
- Essex Junction, VT
National Provider Identifier
1396984548
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0480000920
- Practice address
- 15 Pinecrest Dr
Essex Junction, VT 05452-2912 - Phone
- (802) 288-1087
- Fax
- (802) 878-4404
- NPI assigned
- Feb 11, 2009
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Psychologist | 103TC0700X | 0480000920 | VT | Primary |
Addresses
Primary practice location
15 Pinecrest Dr
Essex Junction, VT 05452-2912
Mailing address
86 Lake St
Burlington, VT 05401-5297
Phone (802) 865-3450
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
| License | State | Type | Specialty |
|---|---|---|---|
| 0480000920 | VT | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1234310400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1234310400000",
"number": "1396984548",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "86 LAKE ST",
"city": "BURLINGTON",
"state": "VT",
"postal_code": "054015297",
"telephone_number": "802-865-3450",
"fax_number": "802-860-5011"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "15 PINECREST DR",
"city": "ESSEX JUNCTION",
"state": "VT",
"postal_code": "054522912",
"telephone_number": "802-288-1087",
"fax_number": "802-878-4404"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIEBERMAN",
"first_name": "BETHANY",
"middle_name": "A.",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2009-02-11",
"last_updated": "2009-02-11",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "VT",
"license": "0480000920",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Essex Junction, VT
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 11, 2009; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.