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Organization
LIGHT LINE THERAPY LCSW, PLLC
Active
Organization
LIGHT LINE THERAPY LCSW, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
JACOB MERGENDOLLER LCSW (MEMBER-MANAGER)
(415) 686-1385
Entity
Organization
Contact information
Practice address
276 5TH AVE RM 604, NEW YORK, NY 10001-4527
(973) 664-7196
Mailing address
276 5TH AVE RM 604, NEW YORK, NY 10001-4527
(973) 664-7196
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—
Other
Enumeration date
03/25/2026
Last updated
03/25/2026
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