Provider Demographics
NPI:1912749177
Name:LIMINAL SPACE THERAPY P.L.L.C
Entity type:Organization
Organization Name:LIMINAL SPACE THERAPY P.L.L.C
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MENTAL HEALTH THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:MONIKA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHONTZ
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:980-236-0916
Mailing Address - Street 1:400 W NORTH ST APT 1204
Mailing Address - Street 2:
Mailing Address - City:RALEIGH
Mailing Address - State:NC
Mailing Address - Zip Code:27603-1567
Mailing Address - Country:US
Mailing Address - Phone:941-525-3025
Mailing Address - Fax:
Practice Address - Street 1:400 W NORTH ST APT 1204
Practice Address - Street 2:
Practice Address - City:RALEIGH
Practice Address - State:NC
Practice Address - Zip Code:27603-1567
Practice Address - Country:US
Practice Address - Phone:941-525-3025
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-06-10
Last Update Date:2024-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Multi-Specialty