MEDICARE: LOVE & KINDNESS WELLNESS SERVICES, LLC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy
1	101YM0800X	Mental Health Counselor
2	103K00000X	Behavior Analyst
3	1041C0700X	Clinical Social Worker
4	261QM0801X	Mental Health Clinic/Center (Including Community Mental Health Center)
5	103TC0700X	Clinical Psychologist

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program
2	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1215417126
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	LOVE & KINDNESS WELLNESS SERVICES, LLC

Provider Business Mailing Address
First Line	:	108 KENILWORTH PL STE 2
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-2439
Country	:	US
Telephone Number	:	347-627-8400
Fax Number	:

Provider Business Practice Location Address
First Line	:	108 KENILWORTH PL FL 1
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11210-2439
Country	:	US
Telephone Number	:	347-835-0010
Fax Number	:

Authorized Official
Title or Position	:	CLINICIAN
Name	:	BEATRICE HYACINTHE
Credential	:	LCSW
Telephone Number	:	347-835-0010

Provider Enumeration Date	:	08/20/2018
Last Update Date	:	04/29/2020

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Directions to “LOVE & KINDNESS WELLNESS SERVICES, LLC ” Practice Location

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