Healthcare Provider Details

I. General information

NPI: 1063746436
Provider Name (Legal Business Name): MARIA PORINCHAK LMHC (NY), LPCC (NM)
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 10/01/2009
Last Update Date: 02/03/2025
Certification Date: 02/03/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

3212 MONTE VISTA BLVD NE
ALBUQUERQUE NM
87106-2120
US

IV. Provider business mailing address

206 EDITH BLVD NE
ALBUQUERQUE NM
87102-3526
US

V. Phone/Fax

Practice location:
  • Phone: 646-820-3740
  • Fax:
Mailing address:
  • Phone: 202-344-6733
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License NumberCTB-2022-0766
License Number StateNM
# 2
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number007820
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: