Safe Space Licensed Clinical Social Work, P.c. - Medicare Mental Health Clinic in Bronx, NY

Safe Space Licensed Clinical Social Work, P.c. is a medicare enrolled mental health clinic (Social Worker - Clinical) in Bronx, New York. The current practice location for Safe Space Licensed Clinical Social Work, P.c. is 3249 Kingsbridge Ave, Bronx, New York. For appointments, you can reach them via phone at (917) 969-2445. The mailing address for Safe Space Licensed Clinical Social Work, P.c. is 8810 Fox Dr, Polk City, Florida and phone number is (863) 738-7808.

Safe Space Licensed Clinical Social Work, P.c. is licensed to practice in * (Not Available) (license number ). The clinic also participates in the medicare program and its NPI number is 1003575358. This medical practice accepts medicare insurance (which means this clinic accepts the Medicare-approved amount; you will not be billed for any more than the Medicare deductible and coinsurance). However, please confirm if they accept your insurance at (917) 969-2445.

Contact Information

Safe Space Licensed Clinical Social Work, P.c.
3249 Kingsbridge Ave
Bronx
NY 10463-5514
(917) 969-2445
Not Available

Mental Health Clinic Profile

Full NameSafe Space Licensed Clinical Social Work, P.c.
SpecialitySocial Worker
Location3249 Kingsbridge Ave, Bronx, New York
Authorized Official Name and PositionMichelle Fuentes (OWNER)
Authorized Official Contact8637387808
Accepts Medicare InsuranceYes. This clinic participates in medicare program and accept medicare insurance.

Mailing Address and Practice Location

Mailing AddressPractice Location Address
Safe Space Licensed Clinical Social Work, P.c.
8810 Fox Dr
Polk City
FL 33868-6024

Ph: (863) 738-7808
Safe Space Licensed Clinical Social Work, P.c.
3249 Kingsbridge Ave
Bronx
NY 10463-5514

Ph: (917) 969-2445

NPI Details:

NPI Number1003575358
Provider Enumeration Date12/14/2021
Last Update Date08/11/2023
Certification Date08/11/2023

Medicare PECOS Information:

Medicare PECOS PAC ID0840654091
Medicare Enrollment IDO20230907000211

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Medical Identifiers

Medical identifiers for Safe Space Licensed Clinical Social Work, P.c. such as npi, medicare ID, medicare PIN, medicaid, etc.
IdentifierTypeStateIssuer
1003575358NPI-NPPES
06578821MedicaidNY

Medical Taxonomies and Licenses

TaxonomyTypeLicense (State)Status
1041C0700XSocial Worker - Clinical (* (Not Available))Primary

Medicare Reassignments

Some practitioners may not bill the customers directly but medicare billing happens through clinics / group practice / hospitals where the provider works. Safe Space Licensed Clinical Social Work, P.c. acts as a billing entity for following providers:
Provider NameJohan Peguero
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1487907044
PECOS PAC ID: 9830464080
Enrollment ID: I20171013002053

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Provider NameMichelle Fuentes
Provider TypePractitioner - Clinical Social Worker
Provider IdentifiersNPI Number: 1104292473
PECOS PAC ID: 7012321607
Enrollment ID: I20210514001922

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Social Worker in Bronx, NY

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Medicare: Not Enrolled in Medicare
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Phone: 718-904-0026    Fax: 718-823-2048
Rajesh Bhatnagar Physician Pc
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Medicare: Medicare Enrolled
Practice Location: 3594 E Tremont Ave Ste 200, Bronx, NY 10465
Phone: 718-239-6987    Fax: 718-239-1601
R.a.s Counseling Services,corp.
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Medicare: Not Enrolled in Medicare
Practice Location: 2435 Jerome Ave, Bronx, NY 10468
Phone: 718-884-2168    Fax: 347-427-3339
Bronx Lebanon Hospital
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Medicare: Not Enrolled in Medicare
Practice Location: 401 E 167th St, Bronx, NY 10456
Phone: 718-590-1800    Fax: 718-579-7330
Sudhir Gadh, Llc
Mental Health Clinic
Medicare: Not Enrolled in Medicare
Practice Location: 432 E 149th St, Bronx, NY 10455
Phone: 718-673-9337    Fax: 718-310-3303
Bebsy Estefan Md Pc
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Medicare: Medicare Enrolled
Practice Location: 3050 Corlear Ave # Phb, Bronx, NY 10463
Phone: 347-248-8145    

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