Organization Active NPI

Mind-Body and Inner-Self Mental Health Counseling PLLC

  • Mental Health Counselor
  • Kew Gardens, NY
National Provider Identifier
1750534905
Registry record updated Jun 2, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
002536 Issued in NY
Legal business name
MIND-BODY AND INNER-SELF MENTAL HEALTH COUNSELING PLLC
Practice address
11929 80TH Rd
Kew Gardens, NY 11415-1105
Phone
(718) 362-0615
NPI assigned
Nov 1, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 2, 2024

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

Authorized official

Name
Mrs. Felicia Ivey-Toure, LMHC, CASACNPI 1285694927
Title
Excutive Director
Phone
(718) 362-0615

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 2

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X 2579 NY
Mental Health CounselorGroup: 193400000X MULTIPLE SINGLE SPECIALTY GROUP 101YM0800X 002536 NY Primary

Addresses

Primary practice location

11929 80TH Rd
Kew Gardens, NY 11415-1105

Mailing address

15206 123Rd Ave
Jamaica, NY 11434-2311
Phone (718) 362-0615

National Provider Directory

National Provider Directory

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": "1225497600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1717286400000",
    "number": "1750534905",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "15206 123RD AVE",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114342311",
            "telephone_number": "718-362-0615"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11929 80TH RD",
            "city": "KEW GARDENS",
            "state": "NY",
            "postal_code": "114151105",
            "telephone_number": "718-362-0615"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIND-BODY AND INNER-SELF MENTAL HEALTH COUNSELING PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-11-01",
        "last_updated": "2024-06-02",
        "certification_date": "2024-06-02",
        "status": "A",
        "authorized_official_last_name": "IVEY-TOURE",
        "authorized_official_first_name": "FELICIA",
        "authorized_official_title_or_position": "EXCUTIVE DIRECTOR",
        "authorized_official_telephone_number": "718-362-0615",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LMHC, CASAC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "2579",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X MULTIPLE SINGLE SPECIALTY GROUP",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "002536",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Kew Gardens, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 2, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.