Organization Active NPI

Real Mind Mental Health Counseling P.C.

  • Mental Health Counselor
  • Staten Island, NY
National Provider Identifier
1790635647
Registry record updated Jan 30, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Legal business name
REAL MIND MENTAL HEALTH COUNSELING P.C.
Practice address
96 Simonson PL
Staten Island, NY 10302-1816
Phone
(347) 681-0419
NPI assigned
Jan 30, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 30, 2026

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

Authorized official

Name
Mrs. Glad Effy Uko-Ima, MA, LMHCNPI 1427773423
Title
President/Owner
Phone
(347) 681-0419

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 1

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

Addresses

Primary practice location

96 Simonson PL
Staten Island, NY 10302-1816

Mailing address

96 Simonson PL
Staten Island, NY 10302-1816
Phone (347) 681-0419

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20260427002935 NY Part B Supplier - Clinic/Group Practice 5294202248 Receives reassigned benefits from 1 practitioner
Practice locations: Staten Island, NY

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": "1769731200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1769731200000",
    "number": "1790635647",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "96 SIMONSON PL",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103021816",
            "telephone_number": "347-681-0419"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "96 SIMONSON PL",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103021816",
            "telephone_number": "347-681-0419"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "REAL MIND MENTAL HEALTH COUNSELING P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-30",
        "last_updated": "2026-01-30",
        "certification_date": "2026-01-30",
        "status": "A",
        "authorized_official_last_name": "UKO-IMA",
        "authorized_official_first_name": "GLAD",
        "authorized_official_middle_name": "EFFY",
        "authorized_official_title_or_position": "PRESIDENT/OWNER",
        "authorized_official_telephone_number": "347-681-0419",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "MA, LMHC"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 30, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.