Provider Demographics
NPI:1457764466
Name:LIEBER, BETTY LUE (MS, PHD, MFT)
Entity type:Individual
Prefix:DR
First Name:BETTY LUE
Middle Name:
Last Name:LIEBER
Suffix:
Gender:F
Credentials:MS, PHD, MFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17664 GREENRIDGE RD
Mailing Address - Street 2:
Mailing Address - City:HIDDEN VALLEY LAKE
Mailing Address - State:CA
Mailing Address - Zip Code:95467-8275
Mailing Address - Country:US
Mailing Address - Phone:925-324-6030
Mailing Address - Fax:
Practice Address - Street 1:17664 GREENRIDGE RD
Practice Address - Street 2:
Practice Address - City:HIDDEN VALLEY LAKE
Practice Address - State:CA
Practice Address - Zip Code:95467-8275
Practice Address - Country:US
Practice Address - Phone:925-324-6030
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-06-06
Last Update Date:2014-06-06
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
CALMFT 12760101YM0800X, 101YP2500X, 106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional