Provider Demographics
NPI:1326458761
Name:CONTEMPORARY COUNSELING LCSW,PLLC
Entity Type:Organization
Organization Name:CONTEMPORARY COUNSELING LCSW,PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:MR
Authorized Official - First Name:LAWRENCE
Authorized Official - Middle Name:
Authorized Official - Last Name:LIEBERMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW-R
Authorized Official - Phone:718-948-1479
Mailing Address - Street 1:3930 RICHMOND AVE STE 104
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10312-5104
Mailing Address - Country:US
Mailing Address - Phone:718-948-1479
Mailing Address - Fax:718-948-1479
Practice Address - Street 1:3930 RICHMOND AVE STE 104
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10312-5104
Practice Address - Country:US
Practice Address - Phone:718-948-1479
Practice Address - Fax:718-948-1479
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2014-05-07
Last Update Date:2016-01-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR024867-1101YM0800X
NY006907-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty