Organization Active NPI

Mind Soul Mental Health Counseling

  • Mental Health Counselor
  • Staten Island, NY
National Provider Identifier
1508558933
Registry record updated Jun 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
MIND SOUL MENTAL HEALTH COUNSELING
Practice address
900 South Ave Ste 300
Staten Island, NY 10314-3428
Phone
(917) 533-9455
Fax
(917) 533-9455
NPI assigned
May 24, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 10, 2025

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

Authorized official

Name
Salma AbdouNPI 1023675204
Title
LMHC
Phone
(917) 533-9455

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193200000X MULTI-SPECIALTY GROUP 101YM0800X Primary

Addresses

Primary practice location

900 South Ave Ste 300
Staten Island, NY 10314-3428

Mailing address

3760 Polar St
Brooklyn, NY 11224-1246

Other practice location 1

3760 Polar St
Brooklyn, NY 11224-1246
Phone (917) 533-9455

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ, NY2 enrollments

Enrollment records 2

Enrollment IDStateProvider typePAC IDDetails
O20250701004837 NJ Part B Supplier - Clinic/Group Practice 1557874674 Receives reassigned benefits from 1 practitioner
Practice locations: Bayonne, NJ
O20250714002241 NY Part B Supplier - Clinic/Group Practice 1557874674 Receives reassigned benefits from 1 practitioner
Practice locations: Brooklyn, NY

National Provider Directory

National Provider Directory

Locations

900 South Ave
Ste 300
Staten Island, NY 10314
Phone (347) 395-3262

Practitioners & affiliated clinicians

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1684886400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749513600000",
    "number": "1508558933",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3760 POLAR ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112241246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "900 SOUTH AVE STE 300",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103143428",
            "telephone_number": "917-533-9455",
            "fax_number": "917-533-9455"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "3760 Polar St",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112241246",
            "country_code": "US",
            "telephone_number": "917-533-9455",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "MIND SOUL MENTAL HEALTH COUNSELING",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-05-24",
        "last_updated": "2025-06-10",
        "certification_date": "2025-06-10",
        "status": "A",
        "authorized_official_last_name": "ABDOU",
        "authorized_official_first_name": "SALMA",
        "authorized_official_title_or_position": "LMHC",
        "authorized_official_telephone_number": "917-533-9455"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 10, 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.