Healthcare Provider Details

I. General information

NPI: 1295945129
Provider Name (Legal Business Name): POTASH MANAGEMENT CORP.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 05/22/2007
Last Update Date: 09/11/2025
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

108 E 91ST ST SUITE 1D
NEW YORK NY
10128-1657
US

IV. Provider business mailing address

108 E 91ST ST SUITE 1D
NEW YORK NY
10128-1657
US

V. Phone/Fax

Practice location:
  • Phone: 212-410-4138
  • Fax:
Mailing address:
  • Phone: 212-410-4138
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number3236
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103TH0100X
TaxonomyHealth Service Psychologist
License Number2263
License Number StateMA
# 3
Primary TaxonomyN
Taxonomy Code106H00000X
TaxonomyMarriage & Family Therapist
License Number529
License Number StateNY
# 4
Primary TaxonomyY
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number2263
License Number StateMA

VIII. Authorized Official

Name: DR. MARLIN SUE POTASH
Title or Position: PRESIDENT
Credential: ED.D.
Phone: 212-410-4138