Individual provider Active NPI

Cheryl A Libera

  • Clinical Social Worker
  • St Petersburg, FL
National Provider Identifier
1467443655
Registry record updated Sep 16, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW6817 Issued in FL
Practice address
1563 Alhambra Way S
St Petersburg, FL 33705-4625
Phone
(727) 865-2293
NPI assigned
Nov 4, 2005
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 16, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X SW6817 FL Primary

Addresses

Primary practice location

1563 Alhambra Way S
St Petersburg, FL 33705-4625

Mailing address

1563 Alhambra Way S
St Petersburg, FL 33705-4625
Phone (727) 415-8754

Other identifiers 1

IdentifierTypeStateIssuer
767368000MedicaidFL

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)
Enrolled

NPI Registry JSON

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

{
    "created_epoch": "1131062400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379289600000",
    "number": "1467443655",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1563 ALHAMBRA WAY S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337054625",
            "telephone_number": "727-415-8754"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1563 ALHAMBRA WAY S",
            "city": "ST PETERSBURG",
            "state": "FL",
            "postal_code": "337054625",
            "telephone_number": "727-865-2293"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIBERA",
        "first_name": "CHERYL",
        "middle_name": "A",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-04",
        "last_updated": "2013-09-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW6817",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "767368000",
            "state": "FL"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in St Petersburg, FL

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 16, 2013; 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.