Organization Active NPI

Liza Bove LCSW Psychotherapy PLLC

  • Clinical Social Worker
  • Goshen, NY
National Provider Identifier
1174204267
Registry record updated Jul 31, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
LIZA BOVE LCSW PSYCHOTHERAPY PLLC
Practice address
305 Main St
Goshen, NY 10924-1638
Phone
(845) 551-8772
Fax
(845) 231-6078
NPI assigned
Jul 31, 2023
Last updated
Jul 31, 2023By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jul 31, 2023

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

Authorized official

Name
Liza Bove, LCSWNPI 1700922200
Title
LCSW/ Ceo
Phone
(845) 551-8772

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X NU Primary

Addresses

Primary practice location

305 Main St
Goshen, NY 10924-1638

Mailing address

178 Highland Ave
Pittsfield, MA 01201-2450
Phone (845) 551-8772

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20230918002812 NY Part B Supplier - Clinic/Group Practice 5193189512 Receives reassigned benefits from 1 practitioner
Practice locations: Goshen, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

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.

NPI Registry JSON

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

{
    "created_epoch": "1690761600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690761600000",
    "number": "1174204267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "178 HIGHLAND AVE",
            "city": "PITTSFIELD",
            "state": "MA",
            "postal_code": "012012450",
            "telephone_number": "845-551-8772"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "305 MAIN ST",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109241638",
            "telephone_number": "845-551-8772",
            "fax_number": "845-231-6078"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIZA BOVE LCSW PSYCHOTHERAPY PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-07-31",
        "last_updated": "2023-07-31",
        "certification_date": "2023-07-31",
        "status": "A",
        "authorized_official_last_name": "BOVE",
        "authorized_official_first_name": "LIZA",
        "authorized_official_title_or_position": "LCSW/ CEO",
        "authorized_official_telephone_number": "845-551-8772",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 31, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.