Healthcare Provider Details

I. General information

NPI: 1750293536
Provider Name (Legal Business Name): BLACK LIBERATION AND COMMUNITY CARE, PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 09/17/2026
Last Update Date: 09/17/2026
Certification Date: 09/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

522 W RIVERSIDE AVE STE 5203
SPOKANE WA
99201-0580
US

IV. Provider business mailing address

522 W RIVERSIDE AVE STE 5203
SPOKANE WA
99201-0580
US

V. Phone/Fax

Practice location:
  • Phone: 347-504-1707
  • Fax:
Mailing address:
  • Phone: 347-504-1707
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code261QM0850X
TaxonomyAdult Mental Health Clinic/Center
License Number
License Number State

VIII. Authorized Official

Name: TAQUESHA DEAN
Title or Position: OWNER
Credential: LSWAIC, MSW, MPH
Phone: 347-524-2956