Active NPI
Judith Lieberstein, PSYD
- Counseling Psychologist
- Westport, CT
National Provider Identifier
1669687992
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counseling Psychologist
- License
- 001991
- Practice address
- 34 Pequot Trail
Westport, CT 06880 - Phone
- (203) 226-9125
- Fax
- (203) 226-7747
- NPI assigned
- May 11, 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 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counseling Psychologist | 103TC1900X | 001991 | CT | Primary |
| Counseling Psychologist | 103TC1900X | 012394 | NY |
Addresses
Primary practice location
34 Pequot Trail
Westport, CT 06880
Mailing address
34 Pequot Trail
Westport, CT 06880
Phone (203) 226-9125
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Apr 7, 2021 through Apr 7, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 001991 | CT | MD | Counseling Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1178841600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1669687992",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "34 PEQUOT TRAIL",
"city": "WESTPORT",
"state": "CT",
"postal_code": "06880",
"telephone_number": "203-226-9125",
"fax_number": "203-226-7747"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "34 PEQUOT TRAIL",
"city": "WESTPORT",
"state": "CT",
"postal_code": "06880",
"telephone_number": "203-226-9125",
"fax_number": "203-226-7747"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIEBERSTEIN",
"first_name": "JUDITH",
"name_prefix": "Dr.",
"credential": "PSYD",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-11",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "CT",
"license": "001991",
"primary": true
},
{
"code": "103TC1900X",
"taxonomy_group": "",
"desc": "Psychologist, Counseling",
"state": "NY",
"license": "012394",
"primary": false
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Westport, CT
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.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.