Safe Space Licensed Clinical Social Work, P.C.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

SAFE SPACE LICENSED CLINICAL SOCIAL WORK, P.C.

Practice address

3249 Kingsbridge Ave
Bronx, NY 10463-5514

Phone

(917) 969-2445

NPI assigned

Dec 14, 2021

Last updated

Aug 11, 2023By the provider in NPPES

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Michelle Fuentes, LCSWNPI 1104292473

Title

Owner

Phone

(863) 738-7808

Specialties & licenses 1

Addresses

Practitioners 4

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Michelle Fuentes

  • Clinical Social Worker
  • Bronx, NY
  • NPI 1104292473
  Authorized official Same address or phone
• Viviana A Schmidt

  • School Social Worker
  • Polk City, FL
  • NPI 1598425597
  NPD
• Rema Sheikah

  • Social Worker
  • Polk City, FL
  • NPI 1588326847

  Single Specialty

  NPD
• Aramis Pourri Sinclair

  • Clinical Social Worker
  • St Petersburg, FL
  • NPI 1043930704
  NPD (past)

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1639440000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1691712000000",
    "number": "1003575358",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8810 FOX DR",
            "city": "POLK CITY",
            "state": "FL",
            "postal_code": "338686024",
            "telephone_number": "863-738-7808"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3249 KINGSBRIDGE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104635514",
            "telephone_number": "917-969-2445"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE SPACE LICENSED CLINICAL SOCIAL WORK, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-12-14",
        "last_updated": "2023-08-11",
        "certification_date": "2023-08-11",
        "status": "A",
        "authorized_official_last_name": "FUENTES",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "863-738-7808",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Houssein Safa, MD
• Julie A Safar, LMSW
• Mohammad Mujtaba Safdar
• Wasif Safdar
• Safe Health Medical Care PLLC
• Safe Space Therapy Services, LCSW, PLLC
• Safeway Pharmacy Inc (Safeway Pharmacy)
• Shawheen Shawn Saffari, D.M.D.
• Don Andrew Safferstein, DDS
• Safia Pharmacy Inc (Lydig Pharmacy)

• Clinical Social Worker in Bronx, NY
• Providers in Bronx, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.