Organization
SAFE SPACE THERAPY SERVICES, LCSW, PLLC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER B JACKSON LCSW-R (FOUNDER/ CEO)
(347) 281-8188
Entity
Organization
Contact information
Practice address
1952 WILLIAMSBRIDGE RD STE 2, BRONX, NY 10461-1605
(347) 281-8188
(718) 303-4314
Mailing address
1162 E 223RD ST, BRONX, NY 10466-5833
(347) 281-8188
(718) 303-4314
Taxonomy
Speciality
Code
Description
License number
State
261QM0801X
Mental Health Clinic/Center (Including Community Mental Health Center)
Primary
072171
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
05
—
03148987
—
NY
Enumeration date
08/03/2015
Last updated
06/07/2022
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