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General NPI Number Information
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NPI Number | 1932708922
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Entity Type | Organization
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Legal Business Name | HOPESPACE MENTAL HEALTH COUNSELING, PLLC
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Dates
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Enumeration Date | 10/20/2020
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Last Update Date | 08/02/2021
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Provider Practice Location Address
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Address Line | 939 ROUTE 146 STE 610
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City | CLIFTON PARK
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State | NY
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Zip | 12065-3662
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Country | US
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Telephone | 518-219-8232
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Fax | 518-219-0744
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Provider Business Mailing Address
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Address Line | 939 ROUTE 146 STE 610
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City | CLIFTON PARK
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State | NY
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Zip | 12065-3662
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Country | US
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Telephone | 518-219-8232
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Fax | 518-219-0744
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Authorized Official
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Title or Position | OWNER
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Name | NICOLE VISCUSI
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Credential | LMHC
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Telephone | 518-219-8232
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number |
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License Number State |
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