Provider Demographics
NPI:1124593215
Name:LIATT, BECK SUSAN (LCSW)
Entity type:Individual
Prefix:
First Name:BECK
Middle Name:SUSAN
Last Name:LIATT
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:47 DEBEVOISE ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11206-4193
Mailing Address - Country:US
Mailing Address - Phone:203-913-0420
Mailing Address - Fax:
Practice Address - Street 1:869 PARK AVE APT 4C
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11206-7336
Practice Address - Country:US
Practice Address - Phone:203-913-0420
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2018-10-04
Last Update Date:2024-10-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1105421041C0700X
NY0973861041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical