| Footprints Mental Health Counseling, P. C. | |
|
3249 Kingsbridge Ave Bronx NY 10463-5514 | |
| (646) 204-2295 | |
| (347) 332-4145 |
| Full Name | Footprints Mental Health Counseling, P. C. |
|---|---|
| Speciality | Counselor |
| Location | 3249 Kingsbridge Ave, Bronx, New York |
| Authorized Official Name and Position | Danielle Luz Matias (CLINICAL ADMINISTRATOR) |
| Authorized Official Contact | 6462042295 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Footprints Mental Health Counseling, P. C. 3249 Kingsbridge Ave Bronx NY 10463-5514 Ph: (929) 330-1065 | Footprints Mental Health Counseling, P. C. 3249 Kingsbridge Ave Bronx NY 10463-5514 Ph: (646) 204-2295 |
| NPI Number | 1033724414 |
|---|---|
| Provider Enumeration Date | 09/11/2020 |
| Last Update Date | 11/01/2022 |
| Certification Date | 11/01/2022 |
| Medicare PECOS PAC ID | 2163836370 |
|---|---|
| Medicare Enrollment ID | O20210129001931 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1033724414 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Delores D Blackwell |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1366536641 PECOS PAC ID: 6204837362 Enrollment ID: I20070117000038 |
| Provider Name | Lezlee T Henry-dupuox |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1699119941 PECOS PAC ID: 1557504685 Enrollment ID: I20130821000400 |
| Provider Name | Lauren Sieber |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1720578321 PECOS PAC ID: 8224385141 Enrollment ID: I20180724002761 |
| Provider Name | Elizabeth Chery |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1841646858 PECOS PAC ID: 4981937307 Enrollment ID: I20190617002475 |
| Provider Name | Michelle Fuentes |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1104292473 PECOS PAC ID: 7012321607 Enrollment ID: I20210514001922 |
| Provider Name | Kyle Calderon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1013531862 PECOS PAC ID: 6305215823 Enrollment ID: I20221206000348 |
| Provider Name | Drusilla White |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1457817389 PECOS PAC ID: 8820469695 Enrollment ID: I20230116000267 |
| Provider Name | Fatima P Santana |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1407562358 PECOS PAC ID: 2769848530 Enrollment ID: I20230522000152 |
| Provider Name | Jacqueline Rolon |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1528425410 PECOS PAC ID: 8820442338 Enrollment ID: I20231002001552 |
| Provider Name | Danielle Luz Matias |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1417372160 PECOS PAC ID: 4981018199 Enrollment ID: I20240125001227 |
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