Individual provider Active NPI

Tianyu Liu

  • Mental Health Counselor
  • Brooklyn, NY
National Provider Identifier
1821848078
Registry record updated Mar 22, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
014439 Issued in NY
Practice address
535 Clinton Ave
Brooklyn, NY 11238-6589
Phone
(718) 704-1986
NPI assigned
Mar 22, 2024
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 22, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 014439 NY Primary

Addresses

Primary practice location

535 Clinton Ave
Brooklyn, NY 11238-6589

Mailing address

800 Harbor Blvd Apt 1407C
Weehawken, NJ 07086-7731
Phone (646) 288-5235

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20250122000421 NY Practitioner - Mental Health Counselor 0749719615 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
014439NYMDSurgical Physician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Jewish Board of Family & Childrens Services Inc CurrentSince Nov 18, 2024 Accepting new patients
Jewish Board of Family and Children'S Services, Inc. CurrentSince Nov 18, 2024 Accepting new patients

Locations

1273 53rd St
Brooklyn, NY 11219
Phone (718) 435-5700

5030 Broadway
Ste 201
New York, NY 10034
Phone (212) 632-4749

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1711065600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1711065600000",
    "number": "1821848078",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "800 HARBOR BLVD APT 1407C",
            "city": "WEEHAWKEN",
            "state": "NJ",
            "postal_code": "070867731",
            "telephone_number": "646-288-5235"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "535 CLINTON AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112386589",
            "telephone_number": "718-704-1986"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIU",
        "first_name": "TIANYU",
        "name_prefix": "Mr.",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2024-03-22",
        "last_updated": "2024-03-22",
        "certification_date": "2021-02-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "014439",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.