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General NPI Number Information
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NPI Number | 1801545652
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Entity Type | Organization
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Legal Business Name | LOVE LIBERATES
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Dates
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Enumeration Date | 03/21/2022
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Last Update Date | 02/14/2025
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Provider Practice Location Address
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Address Line | 3717 N RAVENSWOOD AVE STE 211
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City | CHICAGO
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State | IL
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Zip | 60613-4098
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Country | US
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Telephone | 847-447-6953
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Fax |
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Provider Business Mailing Address
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Address Line | 1333 W GREENLEAF AVE APT 1
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City | CHICAGO
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State | IL
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Zip | 60626-2959
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Country | US
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Telephone | 718-938-4174
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Fax |
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Authorized Official
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Title or Position | CO-FOUNDER, PSYCHOTHERAPIST
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Name | SARAH JANE BOWIE
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Credential | LCSW
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Telephone | 718-938-4174
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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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