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General NPI Number Information
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NPI Number | 1467331744
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Entity Type | Organization
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Legal Business Name | LIZ NICKOLE THERAPY, A LICENSED CLINICAL SOCIAL WORKER PROFESSIONAL CORPORATION
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Dates
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Enumeration Date | 08/29/2025
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Last Update Date | 08/29/2025
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Provider Practice Location Address
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Address Line | 4750 ALMADEN EXPY STE 124-335
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City | SAN JOSE
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State | CA
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Zip | 95118-2052
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Country | US
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Telephone | 408-766-2940
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Fax |
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Provider Business Mailing Address
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Address Line | 4750 ALMADEN EXPY STE 124-335
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City | SAN JOSE
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State | CA
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Zip | 95118-2052
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Country | US
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Telephone | 408-766-2940
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Fax |
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Authorized Official
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Title or Position | PRESIDENT
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Name | MS. ELIZABETH BAUMEISTER
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Credential | LCSW
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Telephone | 408-766-2940
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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