Individual provider Active NPI

Siddiqur Rahman, LMHC

  • Mental Health Counselor
  • East Elmhurst, NY
National Provider Identifier
1952037038
Registry record updated Jul 29, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
0-12664 Issued in NY
Practice address
2258 78TH St FL 3
East Elmhurst, NY 11370-2102
Phone
(646) 270-5906
NPI assigned
Jul 29, 2022
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Jul 29, 2022

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 0-12664 NY Primary

Addresses

Primary practice location

2258 78TH St FL 3
East Elmhurst, NY 11370-2102

Mailing address

2258 78TH St FL 3
East Elmhurst, NY 11370-2102
Phone (646) 270-5906

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
I20240307000303 NY Practitioner - Mental Health Counselor 7315383858 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
0-12664NYMDMental Health Counselor

Practice roles

OrganizationSpecialtyStatusNew patients
Interborough Developmental and Consultation Center, Inc. CurrentSince Feb 7, 2024 Accepting new patients
Interborough Developmental and Consultation Center, Inc. CurrentSince Feb 7, 2024 Accepting new patients

Locations

1623 Kings Hwy
Brooklyn, NY 11229
Phone (718) 307-6800

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": "1659052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1659052800000",
    "number": "1952037038",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2258 78TH ST FL 3",
            "city": "EAST ELMHURST",
            "state": "NY",
            "postal_code": "113702102",
            "telephone_number": "646-270-5906"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2258 78TH ST FL 3",
            "city": "EAST ELMHURST",
            "state": "NY",
            "postal_code": "113702102",
            "telephone_number": "646-270-5906"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "RAHMAN",
        "first_name": "SIDDIQUR",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-07-29",
        "last_updated": "2022-07-29",
        "certification_date": "2022-07-29",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "0-12664",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Elmhurst, NY

Sources for this page

Verify at the official NPI Registry.