MEDICARE: KELLY HERNANDEZ-ARRIAGA LMHC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor	011017	NY

General Provider Information

NPI Number	:	1205702727
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	KELLY HERNANDEZ-ARRIAGA LMHC

Provider Business Mailing Address
First Line	:	359 STOCKHOLM ST APT 2L
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11237-4024
Country	:	US
Telephone Number	:	347-502-9466
Fax Number	:

Provider Business Practice Location Address
First Line	:	359 STOCKHOLM ST APT 2L
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11237-4024
Country	:	US
Telephone Number	:	347-502-9466
Fax Number	:

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	10/13/2025
Last Update Date	:	10/13/2025

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