| Hereba Mental Health Counseling, Lmhc, Pc | |
|
124 Northern Lights Dr Ste 30 North Syracuse NY 13212-4119 | |
| (315) 552-0201 | |
| Not Available |
| Full Name | Hereba Mental Health Counseling, Lmhc, Pc |
|---|---|
| Speciality | Counselor - Mental Health |
| Location | 124 Northern Lights Dr Ste 30, North Syracuse, New York |
| Authorized Official Name and Position | Leslie Shaffer Hereba (OWNER) |
| Authorized Official Contact | 3155520201 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Hereba Mental Health Counseling, Lmhc, Pc 115 Gorland Ave Syracuse NY 13224-1615 Ph: (315) 256-7985 | Hereba Mental Health Counseling, Lmhc, Pc 124 Northern Lights Dr Ste 30 North Syracuse NY 13212-4119 Ph: (315) 552-0201 |
| NPI Number | 1275199291 |
|---|---|
| Provider Enumeration Date | 05/15/2019 |
| Last Update Date | 06/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1275199291 | NPI | - | NPPES |
| 1649648114 | Other | NPI-1 |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
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