Individual provider Active NPI

Evita Alba Colon, LMHC

  • Mental Health Counselor
  • Forest Hills, NY
National Provider Identifier
1073949566
Registry record updated Sep 17, 2013
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
P87334 Issued in NY
Practice address
10420 Queens Blvd
Suite 22C
Forest Hills, NY 11375-3629
Phone
(516) 661-8947
NPI assigned
Sep 17, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 17, 2013

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X P87334 NY Primary

Addresses

Primary practice location

10420 Queens Blvd
Suite 22C
Forest Hills, NY 11375-3629

Mailing address

412 E 119TH St
New York, NY 10035-3626
Phone (917) 318-2640

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20240328002588 NY Practitioner - Mental Health Counselor 2668819442 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P87334NYMDMental Health Counselor
006589NYMDClinical Child & Adolescent Psychologist

Practice roles

OrganizationSpecialtyStatusNew patients
Families and Individuals in Recovery CurrentSince Feb 10, 2024 Accepting new patients
Metropolitan Center for Mental Health, Inc. CurrentSince Feb 10, 2024 Accepting new patients

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1379376000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1379376000000",
    "number": "1073949566",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "412 E 119TH ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100353626",
            "telephone_number": "917-318-2640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "10420 QUEENS BLVD",
            "address_2": "SUITE 22C",
            "city": "FOREST HILLS",
            "state": "NY",
            "postal_code": "113753629",
            "telephone_number": "516-661-8947"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COLON",
        "first_name": "EVITA",
        "middle_name": "ALBA",
        "name_prefix": "Ms.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-09-17",
        "last_updated": "2013-09-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P87334",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Forest Hills, NY

Sources for this page

Verify at the official NPI Registry.