Individual provider Active NPI

Marian Mikhail

  • Mental Health Counselor
  • Staten Island, NY
National Provider Identifier
1265157911
Registry record updated Mar 10, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
010409 Issued in NY
Practice address
500 Todt Hill Rd
Staten Island, NY 10304-1326
Phone
(330) 550-0258
NPI assigned
Oct 5, 2022
Last updated
Mar 10, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 10, 2026

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

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X 010409 NY Primary
Professional Counselor 101YP2500X PC017924 PA
Professional Counselor 101YP2500X 37PC00944500 NJ

Addresses

Primary practice location

500 Todt Hill Rd
Staten Island, NY 10304-1326

Mailing address

500 Todt Hill Rd
Staten Island, NY 10304-1326
Phone (330) 550-0258

Other identifiers 1

IdentifierTypeStateIssuer
JLJ727526469MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in PA, NJ, NY3 enrollments
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 3

Enrollment IDStateProvider typePAC IDDetails
I20241208000033 PA Practitioner - Mental Health Counselor 3870029390 Reassigns benefits to 2 organizations
I20241208000043 NJ Practitioner - Mental Health Counselor 3870029390 Reassigns benefits to 2 organizations
I20241209000365 NY Practitioner - Mental Health Counselor 3870029390 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2018
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Mental Health Specialty Group NJ PCGroup PAC ID 8224559174, 14 clinicians
Mental Health Specialty Group PAGroup PAC ID 8921466228, 726 clinicians

Practice addresses (Care Compare)

Hackettstown, NJ 07840
Phone (973) 576-5147

1650 Market St
Philadelphia, PA 19103-7301
Phone (323) 205-7088

300 Cadman PLZ W
Brooklyn, NY 11201-3211
Phone (323) 205-7088

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Grow Healthcare Group PA Mental Health CurrentSince Nov 13, 2024 Accepting new patients
Mental Health Specialty Group PA Mental Health CurrentSince Mar 1, 2025 Accepting new patients
Grow Healthcare Group of New Jersey PC Mental Health CurrentSince Nov 13, 2024 Accepting new patients
Shine Medical Providers PC Past Accepting new patients
Shine Medical of Ca PC Past Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

221 River St
Ste 9
Hoboken, NJ 07030
Phone (201) 439-8902

165 Broadway
Fl 23
New York, NY 10006
Phone (202) 972-4964

1626 Locust St
Philadelphia, PA 19103
Phone (215) 709-3177

1650 Market St
Philadelphia, PA 19103
Phone (215) 514-0760

Organizations & group practices 6

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1664928000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1773100800000",
    "number": "1265157911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "500 TODT HILL RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103041326",
            "telephone_number": "330-550-0258"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "500 TODT HILL RD",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103041326",
            "telephone_number": "330-550-0258"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKHAIL",
        "first_name": "MARIAN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-10-05",
        "last_updated": "2026-03-10",
        "certification_date": "2026-03-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "010409",
            "primary": true
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "PA",
            "license": "PC017924",
            "primary": false
        },
        {
            "code": "101YP2500X",
            "taxonomy_group": "",
            "desc": "Counselor, Professional",
            "state": "NJ",
            "license": "37PC00944500",
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "JLJ727526469",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

Verify at the official NPI Registry.