| Talkspace Provider Network Ak, Pc | |
|
2578 Broadway # 607 New York NY 10025-5642 | |
| (212) 284-7206 | |
| Not Available |
| Full Name | Talkspace Provider Network Ak, Pc |
|---|---|
| Speciality | Clinic/Center |
| Location | 2578 Broadway # 607, New York, New York |
| Authorized Official Name and Position | Nikole Benders-hadi (AUTHORIZED OFFICIAL) |
| Authorized Official Contact | 2122847206 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| Talkspace Provider Network Ak, Pc Po Box 659 Portsmouth NH 03802-0659 Ph: (212) 284-7206 | Talkspace Provider Network Ak, Pc 2578 Broadway # 607 New York NY 10025-5642 Ph: (212) 284-7206 |
| NPI Number | 1164299715 |
|---|---|
| Provider Enumeration Date | 12/05/2023 |
| Last Update Date | 01/28/2025 |
| Certification Date | 01/28/2025 |
| Medicare PECOS PAC ID | 5395285084 |
|---|---|
| Medicare Enrollment ID | O20240909002888 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1164299715 | NPI | - | NPPES |
| Provider Name | Letha Richardson |
|---|---|
| Provider Type | Practitioner - Mental Health Counselor |
| Provider Identifiers | NPI Number: 1518196005 PECOS PAC ID: 4082154778 Enrollment ID: I20240909003083 |
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