Individual provider Active NPI

Polok M Kamal

  • Mental Health Counselor
  • Bohemia, NY
National Provider Identifier
1952079527
Registry record updated Aug 31, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
1650 Sycamore Ave Ste 39
Bohemia, NY 11716-1736
Phone
(631) 758-8290
NPI assigned
Aug 31, 2021
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 31, 2021

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

1650 Sycamore Ave Ste 39
Bohemia, NY 11716-1736

Mailing address

8508 168TH PL
Jamaica, NY 11432-2638
Phone (347) 545-6283

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Ronald Villano Mental Health Counselor, PLLC Mental Health CurrentSince Sep 5, 2021 Accepting new patients

Locations

1650 Sycamore Ave
Ste 39
Bohemia, NY 11716

7530 Metropolitan Ave
Ste 102
Middle Village, NY 11379

Organizations & group practices 1

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": "1630368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1630368000000",
    "number": "1952079527",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8508 168TH PL",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114322638",
            "telephone_number": "347-545-6283"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 SYCAMORE AVE STE 39",
            "city": "BOHEMIA",
            "state": "NY",
            "postal_code": "117161736",
            "telephone_number": "631-758-8290"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KAMAL",
        "first_name": "POLOK",
        "middle_name": "M",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-08-31",
        "last_updated": "2021-08-31",
        "certification_date": "2021-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bohemia, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2021; 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.