Individual provider Active NPI

Mateusz Bibik

  • Mental Health Counselor
  • Brooklyn, NY
National Provider Identifier
1235870221
Registry record updated Apr 5, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2579 E 17TH St Ste 28
Brooklyn, NY 11235-3515
Phone
(347) 708-0777
NPI assigned
Apr 5, 2022
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 5, 2022

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

2579 E 17TH St Ste 28
Brooklyn, NY 11235-3515

Mailing address

2579 E 17TH St Ste 28
Brooklyn, NY 11235-3515

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Opted out of Medicare
Yes, effective May 22, 2024 through May 22, 2028

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
014672NYMDPhysician Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
Rothschild Mental Health Counseling PLLC Mental Health CurrentSince Apr 10, 2022 Accepting new patients

Locations

2579 E 17th St
Ste 28
Brooklyn, NY 11235
Phone (347) 708-0777

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": "1649116800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1649116800000",
    "number": "1235870221",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2579 E 17TH ST STE 28",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353515"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2579 E 17TH ST STE 28",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112353515",
            "telephone_number": "347-708-0777"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BIBIK",
        "first_name": "MATEUSZ",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2022-04-05",
        "last_updated": "2022-04-05",
        "certification_date": "2022-04-04",
        "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.