Active NPI
Jeffrey M Kishner, LMHC
- Mental Health Counselor
- Brooklyn, NY
National Provider Identifier
1629285200
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 003751-1
- Practice address
- 135 Prospect Park W
Apt. 14
Brooklyn, NY 11215-4267 - Phone
- (347) 423-4631
- NPI assigned
- May 16, 2007
- Sex
- Male
- 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 | 003751-1 | NY | Primary |
Addresses
Primary practice location
135 Prospect Park W
Apt. 14
Brooklyn, NY 11215-4267
Mailing address
82 Nassau St # 60397
New York, NY 10038-3703
Phone (347) 394-7841
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Opted out of Medicare
- Yes, effective Dec 5, 2025 through Dec 5, 2027
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 003751-1 | NY | MD | Surgical Physician Assistant |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179273600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1629849600000",
"number": "1629285200",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "82 NASSAU ST # 60397",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100383703",
"telephone_number": "347-394-7841"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "135 PROSPECT PARK W",
"address_2": "APT. 14",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112154267",
"telephone_number": "347-423-4631"
}
],
"practiceLocations": [],
"basic": {
"last_name": "KISHNER",
"first_name": "JEFFREY",
"middle_name": "M",
"name_prefix": "Mr.",
"credential": "LMHC",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2007-05-16",
"last_updated": "2021-08-25",
"certification_date": "2021-08-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "003751-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 25, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.