Liberty Treatment of Virginia

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

LIBERTY TREATMENT OF VIRGINIA

Practice address

55 Great Meadow LN
Avon, CT 06001-4549

Phone

(959) 226-8411

NPI assigned

Jan 24, 2024

Last updated

Jan 24, 2024By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Gina Rose, LCSWNPI 1194185686

Title

Owner

Phone

(959) 226-8411

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Gina Rose, LCSW

  • Clinical Social Worker
  • Hampstead, NC
  • NPI 1194185686
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1706054400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1706054400000",
    "number": "1053173195",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "55 GREAT MEADOW LN",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060014549",
            "telephone_number": "959-226-8411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "55 GREAT MEADOW LN",
            "city": "AVON",
            "state": "CT",
            "postal_code": "060014549",
            "telephone_number": "959-226-8411"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIBERTY TREATMENT OF VIRGINIA",
        "organizational_subpart": "NO",
        "enumeration_date": "2024-01-24",
        "last_updated": "2024-01-24",
        "certification_date": "2024-01-24",
        "status": "A",
        "authorized_official_last_name": "ROSE",
        "authorized_official_first_name": "GINA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "959-226-8411",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Denise Lepage-Alsakkaf, LCSW
• Rene Lerer, M.D.
• Lori D Lerner, D.O.
• Minoufa Lesperance
• Kimberly Wearne Levesque, L.C.S.W.
• Life Link Transport LLC
• Bryan Lilley, DPT
• Kurtis Lillie, PT
• Juliana Lima, APN
• Angela Maria Liquori, PA-C

• Clinical Social Worker in Avon, CT
• Providers in Avon, CT by specialty
• Clinical Social Worker in Connecticut

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 24, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.