Provider Demographics
NPI:1487477261
Name:LIGHTER BLUE YOU
Entity type:Organization
Organization Name:LIGHTER BLUE YOU
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/FOUNDER
Authorized Official - Prefix:DR
Authorized Official - First Name:TAYLOR
Authorized Official - Middle Name:
Authorized Official - Last Name:KLEIN
Authorized Official - Suffix:
Authorized Official - Credentials:PSYD
Authorized Official - Phone:845-239-6783
Mailing Address - Street 1:697 WASHINGTON ST
Mailing Address - Street 2:
Mailing Address - City:WHITMAN
Mailing Address - State:MA
Mailing Address - Zip Code:02382-1313
Mailing Address - Country:US
Mailing Address - Phone:845-239-6783
Mailing Address - Fax:
Practice Address - Street 1:697 WASHINGTON ST
Practice Address - Street 2:
Practice Address - City:WHITMAN
Practice Address - State:MA
Practice Address - Zip Code:02382-1313
Practice Address - Country:US
Practice Address - Phone:845-239-6783
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-11-01
Last Update Date:2024-11-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health