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Organization
LEIBOW PSYCHOLOGY GROUP, PC
Active
Organization
LEIBOW PSYCHOLOGY GROUP, PC
Active
Other names
Vantage Behavioral Health
Organization subpart
No
Provider details
NPI number
Authorized official
DR. MICHAEL LEIBOW PSYD (PRESIDENT)
(305) 336-1168
Entity
Organization
Contact information
Practice address
11175 CAMPUS ST, LOMA LINDA, CA 92350-1700
(305) 336-1168
Mailing address
8583 IRVINE CENTER DR # 381, IRVINE, CA 92618-4298
(305) 336-1168
Taxonomy
Speciality
Code
Description
License number
State
101YM0800X
Mental Health Counselor
—
—
103TC0700X
Clinical Psychologist
Primary
—
—
103TH0004X
Health Psychologist
—
—
1041C0700X
Clinical Social Worker
—
—
Other
Enumeration date
11/27/2019
Last updated
10/04/2021
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