Individual provider Active NPI

Irene Lin

  • Mental Health Counselor
  • Elmhurst, NY
National Provider Identifier
1659088342
Registry record updated Nov 13, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
015242 Issued in NY
Practice address
4059 Ithaca St
Elmhurst, NY 11373-1402
Phone
(347) 536-1484
NPI assigned
Nov 1, 2022
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Nov 13, 2024

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 015242 NY Primary

Addresses

Primary practice location

4059 Ithaca St
Elmhurst, NY 11373-1402

Mailing address

4059 Ithaca St
Elmhurst, NY 11373-1402
Phone (347) 536-1484

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in TX, MI2 enrollments
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 2

Enrollment IDStateProvider typePAC IDDetails
I20260124000384 TX Practitioner - Mental Health Counselor 8820575442 Reassigns benefits to 1 organization
I20260210003838 MI Practitioner - Mental Health Counselor 8820575442 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Mental Health Counselor
Education
Other, 2022
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

1315 S Adams St
Fort Worth, TX 76104-4404

9500 Bryn Mawr Ave
Suite 300
Rosemont, IL 60018-5218

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
015242NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Telehealth Physician Network, PLLC CurrentSince Jan 5, 2026 Accepting new patients
Telehealth Physician Network, PLLC CurrentSince Feb 3, 2026 Accepting new patients

Locations

2900 West Rd
Ste 500
East Lansing, MI 48823
Phone (617) 249-6854

1315 S Adams St
Fort Worth, TX 76104
Phone (570) 204-6048

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": "1667260800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1731456000000",
    "number": "1659088342",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4059 ITHACA ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731402",
            "telephone_number": "347-536-1484"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4059 ITHACA ST",
            "city": "ELMHURST",
            "state": "NY",
            "postal_code": "113731402",
            "telephone_number": "347-536-1484"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LIN",
        "first_name": "IRENE",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-11-01",
        "last_updated": "2024-11-13",
        "certification_date": "2024-11-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "015242",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.