Individual provider Active NPI

Kevin Goldwater, MA, LMHC

  • Mental Health Counselor
  • Brooklyn, NY
National Provider Identifier
1093387722
Registry record updated Sep 28, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
P110345 Issued in NY
Practice address
200 Franklin St Unit 103
Brooklyn, NY 11222-6867
Phone
(312) 909-0505
NPI assigned
Jul 13, 2021
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 28, 2024

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 P110345 NY Primary

Addresses

Primary practice location

200 Franklin St Unit 103
Brooklyn, NY 11222-6867

Mailing address

200 Franklin St Unit 103
Brooklyn, NY 11222-6867
Phone (312) 909-0505

Other practice location 1

244 5th Ave Ste 2586
New York, NY 10001-7604
Phone (347) 991-0292

Other practice location 2

244 5th Ave Ste 2586
New York, NY 10001-7604
Phone (347) 991-0292

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled
Credentials
Master of Arts

State licenses

LicenseStateTypeSpecialty
P110345NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Goldwater Mental Health Counseling, PLLC Mental Health CurrentSince Sep 29, 2024 Accepting new patients

Locations

200 Franklin St
Unit 103
Brooklyn, NY 11222
Phone (312) 909-0505

Organizations & group practices 1

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": "1626134400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727481600000",
    "number": "1093387722",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 FRANKLIN ST UNIT 103",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112226867",
            "telephone_number": "312-909-0505"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 FRANKLIN ST UNIT 103",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112226867",
            "telephone_number": "312-909-0505"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "244 5th Ave Ste 2586",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100017604",
            "country_code": "US",
            "telephone_number": "347-991-0292",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "244 5th Ave Ste 2586",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100017604",
            "country_code": "US",
            "telephone_number": "347-991-0292",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "GOLDWATER",
        "first_name": "KEVIN",
        "credential": "MA, LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-07-13",
        "last_updated": "2024-09-28",
        "certification_date": "2024-09-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "P110345",
            "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 Sep 28, 2024; 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.