Active NPI
Marla Liberman
- Clinical Psychologist
- Saint Louis, MO
National Provider Identifier
1669525523
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 01193
- Practice address
- 1901 Pennsylvania Ave
Saint Louis, MO 63133-1325 - Phone
- (314) 877-0589
- Fax
- (314) 877-0575
- NPI assigned
- Jan 22, 2007
- 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 | 01193 | MO | Primary |
Addresses
Primary practice location
1901 Pennsylvania Ave
Saint Louis, MO 63133-1325
Mailing address
5351 Delmar Blvd
Mailstop 17
Saint Louis, MO 63112-3146
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 |
|---|---|---|---|
| 01193 | MO | MD | Clinical Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1169424000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669525523",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5351 DELMAR BLVD",
"address_2": "MAILSTOP 17",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631123146"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1901 PENNSYLVANIA AVE",
"city": "SAINT LOUIS",
"state": "MO",
"postal_code": "631331325",
"telephone_number": "314-877-0589",
"fax_number": "314-877-0575"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIBERMAN",
"first_name": "MARLA",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-01-22",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "MO",
"license": "01193",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Saint Louis, MO
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 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.