Active NPI
Lewis R. Lieberman, PH. D.
- Clinical Psychologist
- Columbus, GA
National Provider Identifier
1861530263
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Psychologist
- License
- 205
- Practice address
- 1501 13TH St
Suite J
Columbus, GA 31901-2383 - Phone
- (706) 322-8264
- Fax
- (706) 569-8387
- NPI assigned
- Feb 1, 2007
- Sex
- Male
- 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 | 205 | GA | Primary |
Addresses
Primary practice location
1501 13TH St
Suite J
Columbus, GA 31901-2383
Mailing address
1501 13TH St
Suite J
Columbus, GA 31901-2383
Phone (706) 322-8264
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 000052401B | Medicaid | GA | |
| 205 | Other | GA | PSYCHOLOGY LICENSE NUMBER |
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)
- Enrolled
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 205 | GA | MD | Clinical Psychologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Lewis R. Lieberman, Incorporated | Clinical | Past | Accepting new patients |
| Adult and Child Psychological Services | Past | 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.
-
- Psychologist
- Columbus, GA
- NPI 1831234103
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1170288000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183939200000",
"number": "1861530263",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "1501 13TH ST",
"address_2": "SUITE J",
"city": "COLUMBUS",
"state": "GA",
"postal_code": "319012383",
"telephone_number": "706-322-8264",
"fax_number": "706-569-8387"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1501 13TH ST",
"address_2": "SUITE J",
"city": "COLUMBUS",
"state": "GA",
"postal_code": "319012383",
"telephone_number": "706-322-8264",
"fax_number": "706-569-8387"
}
],
"practiceLocations": [],
"basic": {
"last_name": "LIEBERMAN",
"first_name": "LEWIS",
"middle_name": "R.",
"name_prefix": "Dr.",
"credential": "PH. D.",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-02-01",
"last_updated": "2007-07-09",
"status": "A"
},
"taxonomies": [
{
"code": "103TC0700X",
"taxonomy_group": "",
"desc": "Psychologist, Clinical",
"state": "GA",
"license": "205",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "000052401B",
"state": "GA"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "PSYCHOLOGY LICENSE NUMBER",
"identifier": "205",
"state": "GA"
}
],
"endpoints": [],
"other_names": []
}Other providers in Columbus, GA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 9, 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.