Individual provider Active NPI

Zachariah Daniel Lieberman, PSYD, MS

  • Clinical Psychologist
  • Holyoke, MA
National Provider Identifier
1902116379
Registry record updated Jun 23, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical PsychologistTaxonomy code 103TC0700X
License
11029 Issued in MA
Practice address
303 Beech St
Holyoke, MA 01040-3968
Phone
(413) 540-1234
NPI assigned
Oct 19, 2010
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jun 23, 2019

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X
Clinical Psychologist 103TC0700X 11029 MA Primary

Addresses

Primary practice location

303 Beech St
Holyoke, MA 01040-3968

Mailing address

PO Box 170
Waterport, NY 14571-0170

Other practice location 1

1695 Main St Ste 300
Springfield, MA 01103-1348
Phone (413) 739-5572

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20200409002235 NY Practitioner - Clinical Psychologist 2860821055 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled
Credentials
Master of Science

State licenses

LicenseStateTypeSpecialty
11029MAMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Che Senior Psychological Services, PC Clinical CurrentSince Jan 7, 2020 Accepting new patients
River Valley Counseling Center, Inc Mental Health PastSince Jul 19, 1994 Accepting new patients

Locations

3512 Quentin Rd
Ste 110
Brooklyn, NY 11234
Phone (718) 854-8370

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": "1287446400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1561248000000",
    "number": "1902116379",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 170",
            "city": "WATERPORT",
            "state": "NY",
            "postal_code": "145710170"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "303 BEECH ST",
            "city": "HOLYOKE",
            "state": "MA",
            "postal_code": "010403968",
            "telephone_number": "413-540-1234"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1695 Main St Ste 300",
            "address_purpose": "LOCATION",
            "city": "Springfield",
            "state": "MA",
            "postal_code": "011031348",
            "country_code": "US",
            "telephone_number": "413-739-5572",
            "fax_number": "413-739-9972",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "LIEBERMAN",
        "first_name": "ZACHARIAH",
        "middle_name": "DANIEL",
        "name_prefix": "Dr.",
        "credential": "PSYD, MS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2010-10-19",
        "last_updated": "2019-06-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "103TC0700X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical",
            "state": "MA",
            "license": "11029",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holyoke, MA

Sources for this page

Verify at the official NPI Registry.