Provider Demographics
NPI:1063200913
Name:REY OF LIGHT THERAPY SERVICES, PLLC
Entity type:Organization
Organization Name:REY OF LIGHT THERAPY SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/ MENTAL HEALTH CLINICIAN
Authorized Official - Prefix:MRS
Authorized Official - First Name:PRISCILLA
Authorized Official - Middle Name:
Authorized Official - Last Name:SANTIAGO
Authorized Official - Suffix:
Authorized Official - Credentials:LICSW
Authorized Official - Phone:508-538-4777
Mailing Address - Street 1:1261 CHURCH ST APT 14
Mailing Address - Street 2:
Mailing Address - City:NEW BEDFORD
Mailing Address - State:MA
Mailing Address - Zip Code:02745-1758
Mailing Address - Country:US
Mailing Address - Phone:508-971-9910
Mailing Address - Fax:
Practice Address - Street 1:1261 CHURCH ST APT 14
Practice Address - Street 2:
Practice Address - City:NEW BEDFORD
Practice Address - State:MA
Practice Address - Zip Code:02745-1758
Practice Address - Country:US
Practice Address - Phone:508-971-9910
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-04-29
Last Update Date:2025-04-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty