Marlin Bonilla

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

012296 Issued in NY

Practice address

1623 Kings Hwy
Brooklyn, NY 11229-1209

Phone

(718) 954-3800

NPI assigned

Apr 4, 2019

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, FL2 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

Specialty

Mental Health Counselor

Education

Other, 2018

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Talkspace Medical Services Ny PCGroup PAC ID 0143671966, 44 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

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.

• Talkspace Medical Services Ny PC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New York, NY
  • NPI 1790475556
  Medicare reassignment Care Compare group NPD
• Talkspace Provider Network PA

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • New York, NY
  • NPI 1639814049

  FL

  Medicare reassignment NPD

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1554336000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1701820800000",
    "number": "1871055020",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1623 KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291209",
            "telephone_number": "718-954-3800"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1623 KINGS HWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112291209",
            "telephone_number": "718-954-3800"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BONILLA",
        "first_name": "MARLIN",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-04-04",
        "last_updated": "2023-12-06",
        "certification_date": "2023-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "012296",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Juan Samuel Ignacio Bonilla-Perez, M.D.
• Aliza Pabua Bonilla, PT
• Anny Madelyn Bonilla, LCSW
• Gaby E Bonilla, MSED
• Lorenzo Rodrigo Bonilla
• Maurice Steve Bonilla Jr., PHARM.D.
• Bonim Lamokom Zichron Moshe Dov
• Patricia R Bonina, MS,PT
• Godslove Kwasi Agyei Bonnah, MBCHB, MPH
• Theressa Bonne-Annee

• Mental Health Counselor in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.