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General NPI Number Information
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NPI Number | 1326458761
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Entity Type | Organization
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Legal Business Name | CONTEMPORARY COUNSELING LCSW,PLLC
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Dates
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Enumeration Date | 05/07/2014
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Last Update Date | 01/11/2016
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Provider Practice Location Address
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Address Line | 3930 RICHMOND AVE STE 104
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City | STATEN ISLAND
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State | NY
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Zip | 10312-5104
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Country | US
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Telephone | 718-948-1479
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Fax | 718-948-1479
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Provider Business Mailing Address
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Address Line | 3930 RICHMOND AVE STE 104
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City | STATEN ISLAND
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State | NY
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Zip | 10312-5104
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Country | US
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Telephone | 718-948-1479
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Fax | 718-948-1479
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Authorized Official
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Title or Position | EXECUTIVE DIRECTOR
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Name | MR. LAWRENCE LIEBERMAN
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Credential | LCSW-R
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Telephone | 718-948-1479
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 006907-1
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License Number State | NY
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | PR024867-1
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License Number State | NY
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