Healthcare Provider Details

I. General information

NPI: 1285542936
Provider Name (Legal Business Name): LIAT RADETSKY LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 09/01/2026
Last Update Date: 09/01/2026
Certification Date: 09/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

184 N MAIN ST
LIBERTY NY
12754-1820
US

IV. Provider business mailing address

184 N MAIN ST
LIBERTY NY
12754-1820
US

V. Phone/Fax

Practice location:
  • Phone: 845-720-0010
  • Fax:
Mailing address:
  • Phone: 845-720-0010
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number132816
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: