Individual provider Active NPI

Krystal Elenia Perez

  • Mental Health Counselor
  • New York, NY
National Provider Identifier
1700432630
Registry record updated Aug 15, 2019
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
2090 7TH Ave
New York, NY 10027-4990
Phone
(212) 553-6606
NPI assigned
Aug 15, 2019
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 15, 2019

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

2090 7TH Ave
New York, NY 10027-4990

Mailing address

590 6TH Ave
New York, NY 10011-2022
Phone (212) 633-9300

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
I20240605001671 NY Practitioner - Mental Health Counselor 7214479278 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
012779NYMDPhysical Therapy Assistant

Practice roles

OrganizationSpecialtyStatusNew patients
The New York Foundling Hospital CurrentSince Apr 23, 2024 Accepting new patients
Grow Healthcare Group PA Mental Health CurrentSince Oct 9, 2025 Accepting new patients
New York Foundling CurrentSince Apr 23, 2024 Accepting new patients

Locations

170 Brown Pl
Bronx, NY 10454
Phone (212) 206-7140

590 Avenue of the Americas
New York, NY 10011
Phone (646) 459-3401

590 Ave of the Americas
Fl 10
New York, NY 10011

165 Broadway
Fl 23
New York, NY 10006
Phone (202) 972-4964

2090 Adam Clayton Powell Jr Blvd
New York, NY 10027
Phone (212) 553-6606

Organizations & group practices 3

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": "1565827200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1565827200000",
    "number": "1700432630",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "590 6TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100112022",
            "telephone_number": "212-633-9300"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2090 7TH AVE",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100274990",
            "telephone_number": "212-553-6606"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PEREZ",
        "first_name": "KRYSTAL",
        "middle_name": "ELENIA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-08-15",
        "last_updated": "2019-08-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

Verify at the official NPI Registry.