Healthcare Provider Details

I. General information

NPI: 1104734599
Provider Name (Legal Business Name): LIU MENTAL HEALTH COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/28/2026
Last Update Date: 08/28/2026
Certification Date: 08/28/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

248 W 105TH ST
NEW YORK NY
10025-3951
US

IV. Provider business mailing address

248 W 105TH ST APT 5A
NEW YORK NY
10025-3932
US

V. Phone/Fax

Practice location:
  • Phone: 609-703-3608
  • Fax:
Mailing address:
  • Phone: 609-703-3608
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: TINA LIU
Title or Position: OWNER
Credential: LMHC
Phone: 609-703-3608