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Contact Information

KENNETH B LIBERTY, PhD
175 W BROADWAY
LINCOLN, ME04457-4000
 Phone: 207-794-6700
 Fax:
 Website:
 

Specialty

Taxonomy Code Specialty Code Provider Type

Clinical

103TC0700X 62 Psychologist, Clinical
Indicates primary specialty

NPI Profile & details for KENNETH B LIBERTY · (Male)

NPI Number 1124371778
Status Active
Credentials PhD
Entity Individual
Enumeration date 10/19/2012
Last updated 02/26/2015 - About 11 years ago
Sole proprietor 1 No
Identifiers
  • ME License # PS1359
  • ME Other 103T00000X ANTHEM BLUE CROSS
Hospital affiliation(s) Not Available
1 A sole proprietor/sole proprietorship is an individual, and as such, is eligible for a single NPI number. The sole proprietor must apply for the NPI number using his or her own Social Security Number (SSN), not an Employer Identification Number (EIN) even if he/she has an EIN.

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