Individual provider Active NPI

Andries Matthys Liebenberg, LPC

  • Professional Counselor
  • Woodstock, GA
National Provider Identifier
1790606499
Registry record updated Jul 21, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Professional CounselorTaxonomy code 101YP2500X
License
LPC017057 Issued in GA
Practice address
409 Old Boring LN
Woodstock, GA 30189-2495
Phone
(770) 928-7300
NPI assigned
Jul 21, 2026
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 21, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Professional Counselor 101YP2500X LPC017057 GA Primary

Addresses

Primary practice location

409 Old Boring LN
Woodstock, GA 30189-2495

Mailing address

2029 Castlemaine Cir
Woodstock, GA 30189-7417
Phone (910) 508-8345

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

Practice roles

OrganizationSpecialtyStatusNew patients
Cherokee Center for Change, Inc Professional Past Accepting new patients
Cherokee Center for Change Counseling, Inc. Professional PastSince Jan 1, 2023 Accepting new patients

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": "1784592000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1784592000000",
    "number": "1790606499",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2029 CASTLEMAINE CIR",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301897417",
            "telephone_number": "910-508-8345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "409 OLD BORING LN",
            "city": "WOODSTOCK",
            "state": "GA",
            "postal_code": "301892495",
            "telephone_number": "770-928-7300"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBENBERG",
        "first_name": "ANDRIES",
        "middle_name": "MATTHYS",
        "credential": "LPC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2026-07-21",
        "last_updated": "2026-07-21",
        "certification_date": "2026-07-21",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "GA",
            "license": "LPC017057",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Woodstock, GA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2026; 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.