Provider Demographics
NPI:1992410955
Name:LOVE LIGHT MENTAL HEALTH COUNSELING SERVICES, PLLC
Entity type:Organization
Organization Name:LOVE LIGHT MENTAL HEALTH COUNSELING SERVICES, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:SHERENE
Authorized Official - Middle Name:STACEY-ANN
Authorized Official - Last Name:HENRY
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC
Authorized Official - Phone:914-426-9384
Mailing Address - Street 1:2005 PALMER AVE # 606
Mailing Address - Street 2:
Mailing Address - City:LARCHMONT
Mailing Address - State:NY
Mailing Address - Zip Code:10538-2437
Mailing Address - Country:US
Mailing Address - Phone:914-440-4722
Mailing Address - Fax:
Practice Address - Street 1:2005 PALMER AVE # 606
Practice Address - Street 2:
Practice Address - City:LARCHMONT
Practice Address - State:NY
Practice Address - Zip Code:10538-2437
Practice Address - Country:US
Practice Address - Phone:914-440-4722
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-01-13
Last Update Date:2023-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty