Healthcare Provider Details

I. General information

NPI: 1558287649
Provider Name (Legal Business Name): J.K. MENTAL HEALTH COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/24/2026
Last Update Date: 06/24/2026
Certification Date: 06/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

5102 21ST ST STE 4A
LONG ISLAND CITY NY
11101-5838
US

IV. Provider business mailing address

5102 21ST ST STE 4A
LONG ISLAND CITY NY
11101-5838
US

V. Phone/Fax

Practice location:
  • Phone: 347-586-6840
  • Fax: 888-552-6718
Mailing address:
  • Phone: 347-586-6840
  • Fax: 888-552-6718

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State

VIII. Authorized Official

Name: MRS. JASNA KOLTOVSKA
Title or Position: OWNER
Credential: LMHC
Phone: 347-586-6840