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General NPI Number Information
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NPI Number | 1992410955
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Entity Type | Organization
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Legal Business Name | LOVE LIGHT MENTAL HEALTH COUNSELING SERVICES, PLLC
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Dates
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Enumeration Date | 01/13/2023
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Last Update Date | 01/13/2023
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Provider Practice Location Address
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Address Line | 2005 PALMER AVE # 606
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City | LARCHMONT
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State | NY
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Zip | 10538-2437
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Country | US
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Telephone | 914-440-4722
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Fax |
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Provider Business Mailing Address
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Address Line | 2005 PALMER AVE # 606
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City | LARCHMONT
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State | NY
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Zip | 10538-2437
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Country | US
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Telephone | 914-440-4722
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Fax |
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Authorized Official
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Title or Position | OWNER
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Name | SHERENE STACEY-ANN HENRY
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Credential | LMHC
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Telephone | 914-426-9384
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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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