Matthew Koziolek, LMHC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

0090171 Issued in NY

Practice address

4404 Queens Blvd FL 2
Sunnyside, NY 11104

Phone

(718) 706-1663

NPI assigned

Sep 29, 2017

Sex

Male

Sole proprietor

Yes

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

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective May 30, 2025 through May 30, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

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.

• Mental Health Providers of Western Queens, Inc.

  • Adult Mental Health Clinic/Center
  • Jackson Heights, NY
  • NPI 1477699791
  NPD (past)

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

{
    "created_epoch": "1506643200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1537747200000",
    "number": "1972012201",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "8305 98TH ST APT 4R",
            "city": "WOODHAVEN",
            "state": "NY",
            "postal_code": "114211695",
            "telephone_number": "917-648-3640"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4404 QUEENS BLVD FL 2",
            "city": "SUNNYSIDE",
            "state": "NY",
            "postal_code": "11104",
            "telephone_number": "718-706-1663"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KOZIOLEK",
        "first_name": "MATTHEW",
        "name_prefix": "Mr.",
        "credential": "LMHC",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-09-29",
        "last_updated": "2018-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "0090171",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• KMK Dental PC
• Andre Erwin Ricardo Knights
• Merissa Ann Kochanski, NP
• Ji-Heun Jonathan Kong, PHARMACIST
• Joel Kouame, LCSW
• Laura Bowers Kreeger, PNP
• Kubikian & Puskulian Prof. Corp.
• Louiza Kubikian, D.D.S.
• Rebecca Kucker, MSW
• Priyanka Kumari, PHARMD

• Mental Health Counselor in Sunnyside, NY
• Providers in Sunnyside, 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 Sep 24, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.