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Organization
HER BLACK THERAPIST LCSW P.C.
Active
Organization
HER BLACK THERAPIST LCSW P.C.
Active
Parent organization
HER BLACK THERAPIST LCSW P.C.
Other names
HER PSYCHOTHERAPY
Organization subpart
Yes
Provider details
NPI number
Legal business name
HER BLACK THERAPIST LCSW P.C.
Authorized official
KALISHA SMITH LCSW CASAC (OWNER/ CEO)
(929) 429-4733
Entity
Organization
Contact information
Practice address
1080 BERGEN ST STE 122, BROOKLYN, NY 11216-3340
(929) 429-4733
Mailing address
1080 BERGEN ST STE 122, BROOKLYN, NY 11216-3340
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
—
101YM0800X
Mental Health Counselor
—
—
104100000X
Social Worker
—
—
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
06020204
—
NY
Enumeration date
05/12/2020
Last updated
01/19/2021
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