NPIMap

Organization Active NPI

The Fortune Society Inc.

  • Addiction (Substance Use Disorder) Counselor
  • Long Island City, NY
National Provider Identifier
1235357237
Registry record updated Dec 1, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Addiction (Substance Use Disorder) CounselorTaxonomy code 101YA0400X
License
141011539 Issued in NY
Legal business name
THE FORTUNE SOCIETY INC.
Practice address
The Fortune Society Inc.
29-76 Northern Blvd 2ND FL
Long Island City, NY 11101-2822
Phone
(212) 691-7554
Fax
(347) 510-3457
NPI assigned
Apr 23, 2007
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2025

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

Authorized official

Name
Sherry Goldstein
Title
VP, Agency Operations
Phone
(212) 691-7554

Specialties & licenses 8

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 061211539 NY
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 17947 NY
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 17241 NY
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 11776 NY
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 19241 NY
Addiction (Substance Use Disorder) CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YA0400X 141011539 NY Primary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X 8095001A NY
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 0483531 NY

Addresses

Primary practice location

The Fortune Society Inc.
29-76 Northern Blvd 2ND FL
Long Island City, NY 11101-2822

Mailing address

29-76 Northern Blvd
2ND FL
Long Island City, NY 11101-2822
Phone (347) 510-3442

Other identifiers 1

IdentifierTypeStateIssuer
02740141MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120307000821 NY Part B Supplier - Clinic/Group Practice 0042479263 Receives reassigned benefits from 19 practitioners
Practice locations: Long Island City, NY; Bronx, NY

National Provider Directory

National Provider Directory

Locations

2976 Northern Blvd
Fl 2
Long Island City, NY 11101
Phone (212) 691-7554

Practitioners & affiliated clinicians

Practitioners 66

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

View all 66

NPI Registry JSON

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

{
    "created_epoch": "1177286400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764547200000",
    "number": "1235357237",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "29-76 NORTHERN BLVD",
            "address_2": "2ND FL",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111012822",
            "telephone_number": "347-510-3442",
            "fax_number": "347-510-3457"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "THE FORTUNE SOCIETY INC.",
            "address_2": "29-76 NORTHERN BLVD 2ND FL",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111012822",
            "telephone_number": "212-691-7554",
            "fax_number": "347-510-3457"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE FORTUNE SOCIETY INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-04-23",
        "last_updated": "2025-12-01",
        "certification_date": "2025-12-01",
        "status": "A",
        "authorized_official_last_name": "GOLDSTEIN",
        "authorized_official_first_name": "SHERRY",
        "authorized_official_title_or_position": "VP, AGENCY OPERATIONS",
        "authorized_official_telephone_number": "212-691-7554"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "061211539",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "17947",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "17241",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "11776",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "19241",
            "primary": false
        },
        {
            "code": "101YA0400X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NY",
            "license": "141011539",
            "primary": true
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "8095001A",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "0483531",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02740141",
            "state": "NY"
        }
    ],
    "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 Dec 1, 2025; 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.