Active NPI
Maryjane I Liebman, PSYD
- Clinical Psychologist
- New York, NY
National Provider Identifier
1659565638
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 0084271
- Practice address
- 280 Riverside Dr
7A
New York, NY 10025-9010 - Phone
- (212) 662-5504
- NPI assigned
- Aug 31, 2007
- Sex
- Female
- 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 | 0084271 | NY | Primary |
Addresses
Primary practice location
280 Riverside Dr
7A
New York, NY 10025-9010
Mailing address
280 Riverside Dr
7A
New York, NY 10025-9010
Phone (212) 662-5504
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| P771337 | Other | NY | OXFORD |
| V956L1 | Other | NY | EMPIRE BC/BS |
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 |
|---|---|---|---|
| 008427 | NY | MD | Mental Health Counselor |
| 0084271 | NY | MD | Speech-Language Pathologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1188518400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1188518400000",
"number": "1659565638",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "280 RIVERSIDE DR",
"address_2": "7A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100259010",
"telephone_number": "212-662-5504"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "280 RIVERSIDE DR",
"address_2": "7A",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100259010",
"telephone_number": "212-662-5504"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIEBMAN",
"first_name": "MARYJANE",
"middle_name": "I",
"credential": "PSYD",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2007-08-31",
"last_updated": "2007-08-31",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "NY",
"license": "0084271",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "OXFORD",
"identifier": "P771337",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "EMPIRE BC/BS",
"identifier": "V956L1",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.