Provider Demographics
NPI:1518473891
Name:LET'S CONQUER THIS, LLC
Entity Type:Organization
Organization Name:LET'S CONQUER THIS, LLC
Other - Org Name:ALYSSA BEER
Other - Org Type:Former Legal Business Name
Authorized Official - Title/Position:PARTNERSHIP
Authorized Official - Prefix:
Authorized Official - First Name:ALYSSA
Authorized Official - Middle Name:
Authorized Official - Last Name:BEER
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:814-566-0374
Mailing Address - Street 1:17 MERLINE AVE
Mailing Address - Street 2:
Mailing Address - City:ERIE
Mailing Address - State:PA
Mailing Address - Zip Code:16509-1567
Mailing Address - Country:US
Mailing Address - Phone:814-566-0374
Mailing Address - Fax:814-920-7108
Practice Address - Street 1:17 MERLINE AVE
Practice Address - Street 2:
Practice Address - City:ERIE
Practice Address - State:PA
Practice Address - Zip Code:16509-1567
Practice Address - Country:US
Practice Address - Phone:814-566-0374
Practice Address - Fax:814-920-7108
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2017-12-21
Last Update Date:2019-06-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PASW129679104100000X
1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty
No104100000XBehavioral Health & Social Service ProvidersSocial WorkerGroup - Single Specialty
Provider Identifiers
StateIdentifier IDID TypeIssuer
PACW020260OtherLCSW LICENSE