| Doctor Name: | MR. MATTHEW A. LIBERATOR |
| NPI Number: | 1215016654 |
| Entity Type Code: | Individual (1) |
| Gender: | M |
| Credentials: | LPC |
| License Number: | 001215 |
| Business Practice Address: | 9504 E 63rd St Suite 213 Raytown, MO - 641334948 |
| Business Phone Number: | 9138943550 |
| Business Fax Number: | 8163560894 |
| Mailing Address: | 9504 E 63rd St, Suite 213 RAYTOWN |
| State: | MO |
| Postal Code: | 641334948 |
| Phone Number: | 9138943550 |
| Fax Number: | 8163560894 |
| NPI Enumeration Date: | 11/05/2006 |
| NPI Last Update Date: | 07/09/2007 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 101YP2500X |
| License Number: | 001215 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | MO |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Counselor |
| Taxonomy Specialization: | Professional |
| Taxonomy Definition: | |