MEDICARE: LION TAMER CONSULTING, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	251S00000X	Community/Behavioral Health Agency

General Provider Information

NPI Number	:	1295325355
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LION TAMER CONSULTING, LLC

Provider Business Mailing Address
First Line	:	471 18TH ST # D3A
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11215-6252
Country	:	US
Telephone Number	:	646-470-4232
Fax Number	:

Provider Business Practice Location Address
First Line	:	525 COURT ST STE C2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11231-3910
Country	:	US
Telephone Number	:	646-470-4232
Fax Number	:

Authorized Official
Title or Position	:	PSYCHOTHERAPIST
Name	:	SARA MONSONIS
Credential	:	LCSW
Telephone Number	:	646-470-4232

Provider Enumeration Date	:	01/22/2021
Last Update Date	:	01/22/2021

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