Individual provider Active NPI

Mattanya Ginsburg

  • Mental Health Counselor
  • Brooklyn, NY
National Provider Identifier
1417723289
Registry record updated Dec 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1623 Kings Hwy
Brooklyn, NY 11229-1209
Phone
(929) 273-7601
NPI assigned
Dec 1, 2023
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 1, 2023

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

1623 Kings Hwy
Brooklyn, NY 11229-1209

Mailing address

1623 Kings Hwy
Brooklyn, NY 11229-1209

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
I20250812001435 NY Practitioner - Mental Health Counselor 3476051129 Reassigns benefits to 2 organizations

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Interborough Developmental and Consultation Center, Inc. CurrentSince Jul 25, 2025 Accepting new patients
Pesach Tikvah Hope Development Inc Mental Health CurrentSince Jul 18, 2025 Accepting new patients
Interborough Developmental and Consultation Center, Inc. CurrentSince Jul 25, 2025 Accepting new patients
Pesach Tikvah Hope Development Inc Mental Health CurrentSince Jul 18, 2025 Accepting new patients

Locations

926 Bedford Ave
Brooklyn, NY 11205
Phone (718) 865-6900

1623 Kings Hwy
Brooklyn, NY 11229
Phone (718) 307-6800

5309 18th Ave
Brooklyn, NY 11204
Phone (718) 705-5190

Organizations & group practices 4

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": "1701388800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701388800000",
    "number": "1417723289",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1623 KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291209"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1623 KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291209",
            "telephone_number": "929-273-7601"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GINSBURG",
        "first_name": "MATTANYA",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2023-12-01",
        "last_updated": "2023-12-01",
        "certification_date": "2023-12-01",
        "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.