NPIMap

Organization Active NPI

JGB Mental Health & Mental Retardation Services Inc

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New York, NY
National Provider Identifier
1255345245
Registry record updated Nov 26, 2025
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
JGB MENTAL HEALTH & MENTAL RETARDATION SERVICES INC
Practice address
250 West 64 Street
4TH FL
New York, NY 10023-6601
Phone
(212) 769-7800
Fax
(212) 769-7869
NPI assigned
Jul 28, 2006
Last updated
Nov 26, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 26, 2025

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

Authorized official

Name
Nicole Hart, JD
Title
General Counsel
Phone
(212) 769-6212

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 6711130 NY
Mental Health Clinic/Center (Including Community Mental Health Center) 261QM0801X Primary
Adult Mental Health Clinic/Center 261QM0850X

Addresses

Primary practice location

250 West 64 Street
4TH FL
New York, NY 10023-6601

Mailing address

250 W 64 St
New York, NY 10023-6301
Phone (212) 769-7800

Other identifiers 1

IdentifierTypeStateIssuer
02994892MedicaidNY

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20050106000297 NY Part B Supplier - Clinic/Group Practice 1850349838 Receives reassigned benefits from 15 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

1630 E 15th St
Fl 2
Brooklyn, NY 11229
Phone (212) 769-6286

15 W 65th St
Fl 7
New York, NY 10023
Phone (212) 712-9968

250 W 64th St
Fl 4
New York, NY 10023

Interoperability endpoints

  • Direct secure messaging: alfonsoc@lighthouseguild.direct.welligent.com
  • Direct secure messaging: babaevai@lighthouseguild.direct.welligent.com
  • Direct secure messaging: brooksteinp@lighthouseguild.direct.welligent.com
  • Direct secure messaging: chanj@lighthouseguild.direct.welligent.com
  • Direct secure messaging: chattmanm@lighthouseguild.direct.welligent.com
  • Direct secure messaging: joym@lighthouseguild.direct.welligent.com
  • Direct secure messaging: millerl@lighthouseguild.direct.welligent.com
  • Direct secure messaging: millers@lighthouseguild.direct.welligent.com
  • Direct secure messaging: newmanl@lighthouseguild.direct.welligent.com
  • Direct secure messaging: paezh@lighthouseguild.direct.welligent.com
  • Direct secure messaging: palc@lighthouseguild.direct.welligent.com
  • Direct secure messaging: ramireza@lighthouseguild.direct.welligent.com
  • Direct secure messaging: reinhards@lighthouseguild.direct.welligent.com
  • Direct secure messaging: rodriguezg@lighthouseguild.direct.welligent.com
  • Direct secure messaging: rosenthalb@lighthouseguild.direct.welligent.com
  • Direct secure messaging: rosse@lighthouseguild.direct.welligent.com
  • Direct secure messaging: sperazzal@lighthouseguild.direct.welligent.com
  • Direct secure messaging: timmonsd@lighthouseguild.direct.welligent.com
  • Direct secure messaging: tokata@lighthouseguild.direct.welligent.com
  • Direct secure messaging: waldemary@lighthouseguild.direct.welligent.com

Practitioners & affiliated clinicians

Practitioners 26

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 26

NPI Registry JSON

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

{
    "created_epoch": "1154044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1764115200000",
    "number": "1255345245",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "250 W 64 ST",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100236301",
            "telephone_number": "212-769-7800",
            "fax_number": "212-769-7869"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "250 WEST 64 STREET",
            "address_2": "4TH FL",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100236601",
            "telephone_number": "212-769-7800",
            "fax_number": "212-769-7869"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "JGB MENTAL HEALTH & MENTAL RETARDATION SERVICES INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-28",
        "last_updated": "2025-11-26",
        "certification_date": "2025-11-26",
        "status": "A",
        "authorized_official_last_name": "HART",
        "authorized_official_first_name": "NICOLE",
        "authorized_official_title_or_position": "GENERAL COUNSEL",
        "authorized_official_telephone_number": "212-769-6212",
        "authorized_official_credential": "JD"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "6711130",
            "primary": false
        },
        {
            "code": "261QM0801X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Mental Health (Including Community Mental Health Center)",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02994892",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 26, 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.