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General NPI Number Information
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NPI Number | 1043144298
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Entity Type | Organization
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Legal Business Name | LIBERTY THROUGH THERAPY PROFESSIONAL CLINICAL COUNSELOR, PC
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Dates
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Enumeration Date | 06/11/2026
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Last Update Date | 06/11/2026
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Provider Practice Location Address
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Address Line | 1777 BOREL PL STE 400
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City | SAN MATEO
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State | CA
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Zip | 94402-3513
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Country | US
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Telephone | 415-429-6130
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Fax | 855-229-3626
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Provider Business Mailing Address
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Address Line | 1777 BOREL PL STE 400
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City | SAN MATEO
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State | CA
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Zip | 94402-3513
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Country | US
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Telephone | 415-429-6130
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Fax | 855-229-3626
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Authorized Official
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Title or Position | CEO / OWNER
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Name | MINJUN WANG
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Credential | LPCC
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Telephone | 415-429-6130
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YP2500X
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Taxonomy Name | Professional Counselor
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License Number |
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License Number State |
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