| Tristan M Leibu | |
|
70 Cornell St East Northport NY 11731-1015 | |
| (631) 606-0333 | |
| Not Available |
| Full Name | Tristan M Leibu |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 70 Cornell St, East Northport, New York |
| Authorized Official Name and Position | Tristan Leibu (LMHC) |
| Authorized Official Contact | 6316060333 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Tristan M Leibu 70 Cornell St East Northport NY 11731-1015 Ph: (631) 606-0333 | Tristan M Leibu 70 Cornell St East Northport NY 11731-1015 Ph: (631) 606-0333 |
| NPI Number | 1598424988 |
|---|---|
| Provider Enumeration Date | 12/13/2021 |
| Last Update Date | 12/13/2021 |
| Certification Date | 12/13/2021 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1598424988 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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