Active NPI
Natasha Fortune, LMHC
- Mental Health Counselor
- Long Island City, NY
National Provider Identifier
1295396190
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 0095241
- Practice address
- 3418 Northern Blvd FL 4
Long Island City, NY 11101 - Phone
- (646) 812-0830
- NPI assigned
- Jun 23, 2019
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 0095241 | NY | Primary |
Addresses
Primary practice location
3418 Northern Blvd FL 4
Long Island City, NY 11101
Mailing address
3418 Northern Blvd FL 4
Long Island City, NY 11101-2236
Phone (646) 812-0830
Other practice location 1
4470 21st St # 3032
Long Island City, NY 11101-5114
Phone (646) 812-0830
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 0095241 | NY | MD | Mental Health Counselor |
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, 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": "1561248000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1563235200000",
"number": "1295396190",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "3418 NORTHERN BLVD FL 4",
"city": "LONG ISLAND CITY",
"state": "NY",
"postal_code": "111012236",
"telephone_number": "646-812-0830"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "3418 NORTHERN BLVD FL 4",
"city": "LONG ISLAND CITY",
"state": "NY",
"postal_code": "11101",
"telephone_number": "646-812-0830"
}
],
"practiceLocations": [
{
"address_1": "4470 21st St # 3032",
"address_purpose": "LOCATION",
"city": "Long Island City",
"state": "NY",
"postal_code": "111015114",
"country_code": "US",
"telephone_number": "646-812-0830",
"fax_number": "718-729-8600",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FORTUNE",
"first_name": "NATASHA",
"name_prefix": "Ms.",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-06-23",
"last_updated": "2019-07-16",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "193400000X SINGLE SPECIALTY GROUP",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "0095241",
"primary": true
}
],
"identifiers": [],
"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 Jul 16, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.