Individual
EVAN FREDRICK LIEBERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
LADC, LGSW
Contact information
Practice address
501 SELBY AVENUE, SAINT PAUL, MN 55102-5510
(847) 721-5639
Mailing address
618 ADAMS ST NE # 1, MINNEAPOLIS, MN 55413-2144
(847) 721-5639
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
303715
MN
1041C0700X
Clinical Social Worker
Primary
25758
MN
Other
Enumeration date
10/20/2016
Last updated
11/29/2021
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