Individual provider Active NPI

Laurie Lieberman, LCSW

  • Clinical Social Worker
  • Teaneck, NJ
National Provider Identifier
1679974307
Registry record updated Mar 13, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SC05871300 Issued in NJ
Practice address
1485 Teaneck Rd
Teaneck, NJ 07666-3626
Phone
(201) 837-9090
Fax
(201) 837-9393
NPI assigned
Sep 12, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 13, 2023

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 44SC05871300 NJ Primary

Addresses

Primary practice location

1485 Teaneck Rd
Teaneck, NJ 07666-3626

Mailing address

1485 Teaneck Rd
Teaneck, NJ 07666-3626
Phone (201) 837-9090

Other practice location 1

506 Hamburg Tpke Ste 102
Wayne, NJ 07470-2068
Phone (201) 837-9090

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20230321000301 NJ Practitioner - Clinical Social Worker 1355715053 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SC05871300NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Family & Children'S Services of Northern New Jersey, Inc. Clinical CurrentSince Feb 22, 2023 Accepting new patients
Jewish Family Service of North Jersey, Inc. PastSince Apr 1, 2020 Accepting new patients

Locations

17-10 River Rd
Fair Lawn, NJ 07410
Phone (201) 796-5151

1485 Teaneck Rd
Teaneck, NJ 07666
Phone (201) 837-9090

506 Hamburg Tpke
Ste 102
Wayne, NJ 07470
Phone (201) 837-9090

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1410480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678665600000",
    "number": "1679974307",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1485 TEANECK RD",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076663626",
            "telephone_number": "201-837-9090",
            "fax_number": "201-837-9393"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1485 TEANECK RD",
            "city": "TEANECK",
            "state": "NJ",
            "postal_code": "076663626",
            "telephone_number": "201-837-9090",
            "fax_number": "201-837-9393"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "506 Hamburg Tpke Ste 102",
            "address_purpose": "LOCATION",
            "city": "Wayne",
            "state": "NJ",
            "postal_code": "074702068",
            "country_code": "US",
            "telephone_number": "201-837-9090",
            "fax_number": "201-837-9393",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIEBERMAN",
        "first_name": "LAURIE",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-09-12",
        "last_updated": "2023-03-13",
        "certification_date": "2023-03-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC05871300",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Teaneck, NJ

Sources for this page

Verify at the official NPI Registry.