Provider Demographics
NPI:1437839875
Name:LIEBISCH, KATE (BCBA)
Entity type:Individual
Prefix:
First Name:KATE
Middle Name:
Last Name:LIEBISCH
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:324 WARD AVE
Mailing Address - Street 2:
Mailing Address - City:BELLEVUE
Mailing Address - State:KY
Mailing Address - Zip Code:41073-1213
Mailing Address - Country:US
Mailing Address - Phone:859-663-1806
Mailing Address - Fax:
Practice Address - Street 1:1130 BOONE AIRE RD
Practice Address - Street 2:
Practice Address - City:FLORENCE
Practice Address - State:KY
Practice Address - Zip Code:41042-1202
Practice Address - Country:US
Practice Address - Phone:859-282-0400
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2023-07-20
Last Update Date:2025-02-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
KY296847103K00000X, 103K00000X
OHRBT-21-162298106S00000X
KYRBT-21-162298106S00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106S00000XBehavioral Health & Social Service ProvidersBehavior Technician
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst