Provider Demographics
NPI:1306997762
Name:LIBERLES-SOFFER, BARBARA INA (LCSW)
Entity type:Individual
Prefix:
First Name:BARBARA
Middle Name:INA
Last Name:LIBERLES-SOFFER
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:407 APRIL WAY
Mailing Address - Street 2:
Mailing Address - City:MIDDLETOWN
Mailing Address - State:NJ
Mailing Address - Zip Code:07748-6510
Mailing Address - Country:US
Mailing Address - Phone:201-871-5896
Mailing Address - Fax:201-871-4775
Practice Address - Street 1:252 W 85TH ST
Practice Address - Street 2:SUITE 1B
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10024-3244
Practice Address - Country:US
Practice Address - Phone:646-505-1680
Practice Address - Fax:201-871-4775
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-14
Last Update Date:2023-03-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJSC076051041C0700X
NYNYSPR0121081041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NJSC07605OtherNJ SOCIAL WORK LICENSE
NYNYSPR012108OtherNYS SOCIAL WORK LICENSE
NJ037851Medicare ID - Type UnspecifiedNJ MEDICARE
NYN46511Medicare ID - Type UnspecifiedNY MEDICARE