Her Black Therapist LCSW P.C.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

HER BLACK THERAPIST LCSW P.C.

Doing business as

Her Psychotherapy

Practice address

1080 Bergen St Ste 122
Brooklyn, NY 11216-3340

Phone

(929) 429-4733

NPI assigned

May 12, 2020

Last updated

Jan 19, 2021By the provider in NPPES

Organization subpart

Yes

Parent organization

HER BLACK THERAPIST LCSW P.C.As reported in NPPES

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

Authorized official

Name

Kalisha Smith, LCSW CASACNPI 1134599236

Title

Owner/ Ceo

Phone

(929) 429-4733

Specialties & licenses 4

Addresses

Other identifiers 1

Other names 1

• HER PSYCHOTHERAPY Doing business as

Part of

Her Black Therapist LCSW PC

Locations

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.

• Kalisha J Smith, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
  • NPI 1134599236
  NPD (past) Authorized official

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

{
    "created_epoch": "1589241600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1611014400000",
    "number": "1457973539",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1080 BERGEN ST STE 122",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112163340"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1080 BERGEN ST STE 122",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112163340",
            "telephone_number": "929-429-4733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "HER BLACK THERAPIST LCSW P.C.",
        "organizational_subpart": "YES",
        "parent_organization_legal_business_name": "HER BLACK THERAPIST LCSW P.C.",
        "enumeration_date": "2020-05-12",
        "last_updated": "2021-01-19",
        "certification_date": "2021-01-19",
        "status": "A",
        "authorized_official_last_name": "SMITH",
        "authorized_official_first_name": "KALISHA",
        "authorized_official_title_or_position": "OWNER/ CEO",
        "authorized_official_telephone_number": "929-429-4733",
        "authorized_official_credential": "LCSW CASAC"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06020204",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "HER PSYCHOTHERAPY",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Sandra W Henson
• Jae Jin Heo, PHARM. D.
• Thema Hepburn
• Frankie C Heppell, LMSW
• Babette Hepperly
• Hae Li Her
• Jennifer Kavita Heralall
• Ghislaine Herard
• Wilfrid Herard, M.D.
• Jessica J Heras

• Clinical Social Worker in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 19, 2021; 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.