Individual
DR. LEWIS R. LIEBERMAN
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
Man
Credential
PH. D.
Contact information
Practice address
1501 13TH ST, SUITE J, COLUMBUS, GA 31901-2383
(706) 322-8264
(706) 569-8387
Mailing address
1501 13TH ST, SUITE J, COLUMBUS, GA 31901-2383
(706) 322-8264
(706) 569-8387
Taxonomy
Speciality
Code
Description
License number
State
103TC0700X
Clinical Psychologist
Primary
205
GA
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
000052401B
—
GA
01
—
205
PSYCHOLOGY LICENSE NUMBER
GA
Enumeration date
02/01/2007
Last updated
07/09/2007
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