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General NPI Number Information
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NPI Number | 1952945792
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Entity Type | Organization
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Legal Business Name | BEACON COUNSELING AND LIFE COACHING
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Dates
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Enumeration Date | 11/05/2019
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Last Update Date | 11/05/2019
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Provider Practice Location Address
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Address Line | 10 BARNET ST
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City | ALBANY
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State | NY
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Zip | 12208-2402
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Country | US
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Telephone | 518-605-6804
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Fax |
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Provider Business Mailing Address
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Address Line | 10 BARNET ST
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City | ALBANY
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State | NY
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Zip | 12208-2402
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Country | US
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Telephone | 518-605-6804
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Fax |
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Authorized Official
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Title or Position | DIRECTOR/OWNER
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Name | MELISSA KOVELMAN
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Credential | LMHC
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Telephone | 518-605-6804
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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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