Active NPI
Paul C. Liebman, PSY.D.
- Clinical Psychologist
- Brooklyn, NY
National Provider Identifier
1407880248
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 012568
- Practice address
- 800 Poly PL
Brooklyn, NY 11209-7104 - Phone
- (718) 836-6600
- NPI assigned
- Jul 10, 2006
- Sex
- Male
- Sole proprietor
- Yes
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 | 012568 | NY | Primary |
Addresses
Primary practice location
800 Poly PL
Brooklyn, NY 11209-7104
Mailing address
1596 212TH St
Bayside, NY 11360-1110
Phone (516) 295-2626
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
Enrollment records 1
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20210914002750 | NY | Practitioner - Clinical Psychologist | 0941485973 | Practice locations: Bayside, NY |
Care Compare profile
Medicare Care Compare- Specialty
- Clinical Psychologist
- Education
- Other, 1994
- Medicare assignment
- May accept Medicare assignment
- Telehealth
- Offers telehealth services
Practice addresses (Care Compare)
1596 212TH St
Bayside, NY 11360-1110
Phone (516) 295-2626
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1152489600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629763200000",
"number": "1407880248",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1596 212TH ST",
"city": "BAYSIDE",
"state": "NY",
"postal_code": "113601110",
"telephone_number": "516-295-2626"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "800 POLY PL",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112097104",
"telephone_number": "718-836-6600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIEBMAN",
"first_name": "PAUL",
"middle_name": "C.",
"name_prefix": "Dr.",
"credential": "PSY.D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2006-07-10",
"last_updated": "2021-08-24",
"certification_date": "2021-08-24",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "012568",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 24, 2021; 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.