NPIMap

Organization Active NPI

New York Counseling for Change, LLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Long Island City, NY
National Provider Identifier
1104456649
Registry record updated Jan 23, 2020
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
NEW YORK COUNSELING FOR CHANGE, LLC
Practice address
3046 Northern Blvd
Long Island City, NY 11101-2816
Phone
(718) 424-6191
Fax
(212) 896-6530
NPI assigned
Jan 23, 2020
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 23, 2020

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

Authorized official

Name
Lawrence Menzie, LCSW
Title
Owner
Phone
(917) 494-3281

Specialties & licenses 1

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

Addresses

Primary practice location

3046 Northern Blvd
Long Island City, NY 11101-2816

Mailing address

12333 83Rd Ave Apt 705
Kew Gardens, NY 11415-3435
Phone (917) 494-3281

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20200429002033 NY Part B Supplier - Clinic/Group Practice 6709216096 Receives reassigned benefits from 11 practitioners
Practice locations: Long Island City, NY

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 13

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

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1579737600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1579737600000",
    "number": "1104456649",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "12333 83RD AVE APT 705",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114153435",
            "telephone_number": "917-494-3281"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3046 NORTHERN BLVD",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111012816",
            "telephone_number": "718-424-6191",
            "fax_number": "212-896-6530"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK COUNSELING FOR CHANGE, LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-01-23",
        "last_updated": "2020-01-23",
        "certification_date": "2020-01-23",
        "status": "A",
        "authorized_official_last_name": "MENZIE",
        "authorized_official_first_name": "LAWRENCE",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "917-494-3281",
        "authorized_official_credential": "LCSW"
    },
    "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 Long Island City, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 23, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.