Individual provider Active NPI

Jacob Klein, LMHC

  • Mental Health Counselor
  • Brooklyn, NY
National Provider Identifier
1326416553
Registry record updated Sep 3, 2015
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
006701 Issued in NY
Practice address
5120 13TH Ave
Brooklyn, NY 11219-3520
Phone
(917) 589-7071
NPI assigned
Sep 3, 2015
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2015

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 006701 NY Primary

Addresses

Primary practice location

5120 13TH Ave
Brooklyn, NY 11219-3520

Mailing address

1555 52ND St
Brooklyn, NY 11219-3999
Phone (917) 589-7071

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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 1

Enrollment IDStateProvider typePAC IDDetails
I20250121000513 NY Practitioner - Mental Health Counselor 9537698527 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
006701NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Community Assistance Resources & Extended Services Inc CurrentSince Jan 16, 2025 Accepting new patients

Locations

465 Grand St
New York, NY 10002
Phone (212) 420-1970

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": "1441238400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1441238400000",
    "number": "1326416553",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1555 52ND ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112193999",
            "telephone_number": "917-589-7071"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5120 13TH AVE",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112193520",
            "telephone_number": "917-589-7071"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLEIN",
        "first_name": "JACOB",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2015-09-03",
        "last_updated": "2015-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "006701",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.