Organization Active NPI

Mind Body Mental Health Counseling Services PLLC

  • Mental Health Counselor
  • Brooklyn, NY
National Provider Identifier
1083495261
Registry record updated Oct 12, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MIND BODY MENTAL HEALTH COUNSELING SERVICES PLLC
Practice address
1416 48TH St
Brooklyn, NY 11219-3243
Phone
(917) 474-5034
NPI assigned
Oct 12, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 12, 2023

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

Authorized official

Name
Menachem M Kiwak, LMHCNPI 1861850430
Title
Owner
Phone
(917) 474-5034

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 CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

1416 48TH St
Brooklyn, NY 11219-3243

Mailing address

9 Knight Dr
Jackson, NJ 08527-5180
Phone (917) 474-5034

Other practice location 1

1170 39th St
Brooklyn, NY 11218-1931
Phone (917) 474-5034

National Provider Directory

National Provider Directory

Locations

1170 39th St
Brooklyn, NY 11218
Phone (917) 474-5034

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": "1697068800000",
    "number": "1083495261",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 KNIGHT DR",
            "city": "JACKSON",
            "state": "NJ",
            "postal_code": "085275180",
            "telephone_number": "917-474-5034"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1416 48TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112193243",
            "telephone_number": "917-474-5034"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1170 39th St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112181931",
            "country_code": "US",
            "telephone_number": "917-474-5034",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIND BODY MENTAL HEALTH COUNSELING SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-10-12",
        "last_updated": "2023-10-12",
        "certification_date": "2023-10-12",
        "status": "A",
        "authorized_official_last_name": "KIWAK",
        "authorized_official_first_name": "MENACHEM",
        "authorized_official_middle_name": "M",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-474-5034",
        "authorized_official_credential": "LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 12, 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.