Provider Demographics
NPI:1548526551
Name:LIEBMAN, ERIN (LCPC)
Entity type:Individual
Prefix:
First Name:ERIN
Middle Name:
Last Name:LIEBMAN
Suffix:
Gender:F
Credentials:LCPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1300 W BELMONT AVE
Mailing Address - Street 2:
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60657-3200
Mailing Address - Country:US
Mailing Address - Phone:312-339-8391
Mailing Address - Fax:
Practice Address - Street 1:450 W BRIAR PL
Practice Address - Street 2:3M
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60657-4737
Practice Address - Country:US
Practice Address - Phone:312-339-8391
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-04-03
Last Update Date:2012-04-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
IL180.007135101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional