| Liberation-based Therapy Lcsw Pllc | |
|
590 Flatbush Avenue #14s Brooklyn NY 11225-4994 | |
| (347) 525-2272 | |
| Not Available |
| Full Name | Liberation-based Therapy Lcsw Pllc |
|---|---|
| Speciality | Social Worker |
| Location | 590 Flatbush Avenue #14s, Brooklyn, New York |
| Authorized Official Name and Position | Tanisha Christie (OWNER) |
| Authorized Official Contact | 3475252272 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Liberation-based Therapy Lcsw Pllc 590 Flatbush Ave #14s Brooklyn NY 11225-4994 Ph: (347) 525-2272 | Liberation-based Therapy Lcsw Pllc 590 Flatbush Avenue #14s Brooklyn NY 11225-4994 Ph: (347) 525-2272 |
| NPI Number | 1255926176 |
|---|---|
| Provider Enumeration Date | 03/02/2021 |
| Last Update Date | 03/02/2021 |
| Certification Date | 03/02/2021 |
| Medicare PECOS PAC ID | 7618330598 |
|---|---|
| Medicare Enrollment ID | O20230824002687 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255926176 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
| Provider Name | Tanisha Sabine Christie |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1356901847 PECOS PAC ID: 8527421403 Enrollment ID: I20230824004076 |
| Provider Name | Rubama Haque |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1609379817 PECOS PAC ID: 5193257327 Enrollment ID: I20241014001406 |
| Provider Name | Sara J Eldridge |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720635147 PECOS PAC ID: 5890220941 Enrollment ID: I20241126001317 |
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