Individual provider Active NPI

Jennifer Rhoades

  • Mental Health Counselor
  • Brooklyn, NY
National Provider Identifier
1215639737
Registry record updated Apr 17, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
790 Broadway
Brooklyn, NY 11206-5316
Phone
(718) 388-5175
NPI assigned
Mar 20, 2023
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 17, 2023

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 Primary

Addresses

Primary practice location

790 Broadway
Brooklyn, NY 11206-5316

Mailing address

790 Broadway
Brooklyn, NY 11206-5316
Phone (718) 388-5175

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
I20260129002351 NY Practitioner - Mental Health Counselor 2062990260 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2026
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1623 Kings Hwy
Brooklyn, NY 11229

3047 Ave U
Brooklyn, NY 11229

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
017387NYMDSpeech-Language Pathologist

Practice roles

OrganizationSpecialtyStatusNew patients
Interborough Developmental and Consultation Center, Inc. CurrentSince Dec 19, 2025 Accepting new patients

Locations

790 Broadway
Brooklyn, NY 11206
Phone (718) 388-5175

1623 Kings Hwy
Brooklyn, NY 11229
Phone (718) 307-6800

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": "1679270400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681689600000",
    "number": "1215639737",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "790 BROADWAY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112065316",
            "telephone_number": "718-388-5175"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "790 BROADWAY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112065316",
            "telephone_number": "718-388-5175"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RHOADES",
        "first_name": "JENNIFER",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-20",
        "last_updated": "2023-04-17",
        "certification_date": "2023-04-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.