Individual provider Active NPI

Jacqueline Porras

  • Mental Health Counselor
  • Brooklyn, NY
National Provider Identifier
1588313621
Registry record updated Dec 18, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
016613-01 Issued in NY
Practice address
2857 Linden Blvd
Brooklyn, NY 11208-5126
Phone
(718) 235-3100
NPI assigned
Mar 23, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 18, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X SINGLE SPECIALTY GROUP 101YM0800X 016613-01 NY Primary

Addresses

Primary practice location

2857 Linden Blvd
Brooklyn, NY 11208-5126

Mailing address

2857 Linden Blvd
Brooklyn, NY 11208-5126

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
I20250901000390 NY Practitioner - Mental Health Counselor 7012418940 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2023
Medicare assignment
May accept Medicare assignment
Telehealth
Offers telehealth services
Group practices
New York Psychotherapy and Counseling CenterGroup PAC ID 4880600147, 113 clinicians

Practice addresses (Care Compare)

2857 Linden Blvd
Brooklyn, NY 11208-5126
Phone (718) 235-3100

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
016613-01NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
New York Psychotherapy and Counseling Center Single Specialty CurrentSince Jun 23, 2025 Accepting new patients
Coordinated Behavioral Care Ipa Inc PastSince Mar 27, 2022 Accepting new patients

Locations

2857 Linden Blvd
Brooklyn, NY 11208
Phone (718) 235-3100

17620 148th Ave
Jamaica, NY 11434
Phone (718) 553-1100

Organizations & group practices 2

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": "1647993600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1766016000000",
    "number": "1588313621",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2857 LINDEN BLVD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112085126"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2857 LINDEN BLVD",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112085126",
            "telephone_number": "718-235-3100"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PORRAS",
        "first_name": "JACQUELINE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-23",
        "last_updated": "2025-12-18",
        "certification_date": "2025-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "016613-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.