Healthcare Provider Details

I. General information

NPI: 1528993524
Provider Name (Legal Business Name): SB THERAPY, LCSW PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/13/2026
Last Update Date: 06/13/2026
Certification Date: 06/12/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

531 50TH AVE
LONG ISLAND CITY NY
11101-6297
US

IV. Provider business mailing address

347 5TH AVE STE 1402-247
NEW YORK NY
10016-5010
US

V. Phone/Fax

Practice location:
  • Phone: 917-397-0291
  • Fax:
Mailing address:
  • Phone: 917-397-0291
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: TARA STARIN-BASI
Title or Position: MANAGING MEMBER
Credential: LCSW-R
Phone: 917-397-0291