Dr. Leslie Liberty

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

DR. LESLIE LIBERTY

Practice address

924 N Yosemite St
Stockton, CA 95203-2217

Phone

(209) 401-5741

NPI assigned

Feb 10, 2021

Organization subpart

No

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

Authorized official

Name

Dr. Leslie S Liberty, DSWNPI 1427649318

Title

Business Owner

Phone

(209) 401-5741

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 2

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Leslie Sutherland Liberty, LCSW, DSW

  • Clinical Social Worker
  • Stockton, CA
  • NPI 1427649318
  NPD Authorized official

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

{
    "created_epoch": "1612915200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1612915200000",
    "number": "1932791985",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "PO BOX 4212",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952040212",
            "telephone_number": "209-401-5741"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "924 N YOSEMITE ST",
            "city": "STOCKTON",
            "state": "CA",
            "postal_code": "952032217",
            "telephone_number": "209-401-5741"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "DR. LESLIE LIBERTY",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-02-10",
        "last_updated": "2021-02-10",
        "certification_date": "2021-02-10",
        "status": "A",
        "authorized_official_last_name": "LIBERTY",
        "authorized_official_first_name": "LESLIE",
        "authorized_official_middle_name": "S",
        "authorized_official_title_or_position": "BUSINESS OWNER",
        "authorized_official_telephone_number": "209-401-5741",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "DSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BOARD OF BEHAVIORAL SCIENCES",
            "identifier": "LCSW7173",
            "state": "CA"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "STOCKTON",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "924 N Yosemite St",
            "city": "Stockton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "952032217",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "drleslieliberty@gmail.com",
            "affiliation": "N",
            "endpointDescription": "email address",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "924 N Yosemite St",
            "city": "Stockton",
            "state": "CA",
            "country_code": "US",
            "postal_code": "952032217",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Adult Mental Health Clinic/Center in Stockton, CA
• Providers in Stockton, CA by specialty
• Adult Mental Health Clinic/Center in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2021; 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.