Provider Demographics
NPI:1821253071
Name:BLIFFELD, SEBASTIAN (LMFT)
Entity Type:Individual
Prefix:
First Name:SEBASTIAN
Middle Name:
Last Name:BLIFFELD
Suffix:
Gender:M
Credentials:LMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5614 NETHERLAND AVE APT 2G
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10471-1843
Mailing Address - Country:US
Mailing Address - Phone:646-344-2973
Mailing Address - Fax:
Practice Address - Street 1:5614 NETHERLAND AVE APT 2G
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10471-1843
Practice Address - Country:US
Practice Address - Phone:646-344-2973
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2008-07-26
Last Update Date:2023-12-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY000903-01106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist