David Bruce Lieberman, BA, MS, CAS

Primary specialty

School PsychologistTaxonomy code 103TS0200X

Practice address

2 Country Club Rd
Queensbury, NY 12804-1702

Phone

(518) 926-2050

NPI assigned

Oct 24, 2018

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

Credentials

Bachelor of Arts, Master of Science

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

{
    "created_epoch": "1540339200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1540339200000",
    "number": "1902373384",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "44 FOX HOLLOW LN",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128041142",
            "telephone_number": "518-745-1120"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2 COUNTRY CLUB RD",
            "city": "QUEENSBURY",
            "state": "NY",
            "postal_code": "128041702",
            "telephone_number": "518-926-2050"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIEBERMAN",
        "first_name": "DAVID",
        "middle_name": "BRUCE",
        "name_prefix": "Mr.",
        "credential": "BA, MS, CAS",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-10-24",
        "last_updated": "2018-10-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TS0200X",
            "taxonomy_group": "",
            "desc": "Psychologist, School",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "00314998",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

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• School Psychologist in Queensbury, NY
• Providers in Queensbury, NY by specialty
• School Psychologist in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 24, 2018; 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.