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General NPI Number Information
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NPI Number | 1982568168
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Entity Type | Organization
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Legal Business Name | LIBERTY ARMS COUNSELING LCSW PC
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Dates
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Enumeration Date | 12/12/2025
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Last Update Date | 12/12/2025
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Provider Practice Location Address
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Address Line | 970 SUNRISE HWY
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City | WEST BABYLON
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State | NY
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Zip | 11704-6110
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Country | US
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Telephone | 631-914-9494
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Fax | 631-914-9494
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Provider Business Mailing Address
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Address Line | 83 TIPTON DR E
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City | SHIRLEY
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State | NY
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Zip | 11967-3616
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Country | US
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Telephone | 631-914-9494
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Fax | 631-914-9494
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Authorized Official
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Title or Position | AUTHORIZED OFFICIAL OF LIBERTY ARMS
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Name | ROBIN R GARDNER
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Credential |
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Telephone | 516-819-9769
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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 |
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License Number State |
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