Organization Active NPI

Poder Mental Health Counseling PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New York, NY
National Provider Identifier
1073394243
Registry record updated Oct 18, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health Clinic/Center (Including Community Mental Health Center)Taxonomy code 261QM0801X
Legal business name
PODER MENTAL HEALTH COUNSELING PLLC
Practice address
5030 Broadway Ste 630
New York, NY 10034-1611
Phone
(646) 470-0639
Fax
(516) 490-7472
NPI assigned
Oct 12, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 18, 2023

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

Authorized official

Name
Alexmi Polanco, LMHCNPI 1770095978
Title
Owner
Phone
(646) 470-0639

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary

Addresses

Primary practice location

5030 Broadway Ste 630
New York, NY 10034-1611

Mailing address

5030 Broadway Ste 630
New York, NY 10034-1611
Phone (646) 470-0639

National Provider Directory

National Provider Directory

Locations

5030 Broadway
Ste 630
New York, NY 10034
Phone (646) 470-0639

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1697068800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1697587200000",
    "number": "1073394243",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5030 BROADWAY STE 630",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100341611",
            "telephone_number": "646-470-0639"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5030 BROADWAY STE 630",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100341611",
            "telephone_number": "646-470-0639",
            "fax_number": "516-490-7472"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PODER MENTAL HEALTH COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-12",
        "last_updated": "2023-10-18",
        "certification_date": "2023-10-18",
        "status": "A",
        "authorized_official_last_name": "POLANCO",
        "authorized_official_first_name": "ALEXMI",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "646-470-0639",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 18, 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.