Provider Demographics
NPI:1679356638
Name:RADIANCE MENTAL HEALTH COUNSELING, PLLC
Entity type:Organization
Organization Name:RADIANCE MENTAL HEALTH COUNSELING, PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:GAIL
Authorized Official - Middle Name:MENTAL HEALTH COUNSE
Authorized Official - Last Name:NEWMAN
Authorized Official - Suffix:
Authorized Official - Credentials:LMHC-D
Authorized Official - Phone:518-992-6422
Mailing Address - Street 1:350 NORTHERN BLVD STE 324-1453
Mailing Address - Street 2:
Mailing Address - City:ALBANY
Mailing Address - State:NY
Mailing Address - Zip Code:12204-1000
Mailing Address - Country:US
Mailing Address - Phone:518-217-0849
Mailing Address - Fax:518-992-6422
Practice Address - Street 1:350 NORTHERN BLVD STE 324-1453
Practice Address - Street 2:
Practice Address - City:ALBANY
Practice Address - State:NY
Practice Address - Zip Code:12204-1000
Practice Address - Country:US
Practice Address - Phone:518-714-1001
Practice Address - Fax:518-217-0849
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-08-15
Last Update Date:2025-01-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Multi-Specialty