Healthcare Provider Details

I. General information

NPI: 1154261295
Provider Name (Legal Business Name): KRYSTAL ORTIZ LMHC MENTAL HEALTH COUNSELING PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/30/2026
Last Update Date: 06/11/2026
Certification Date: 06/11/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

6344 SAUNDERS ST
REGO PARK NY
11374-2039
US

IV. Provider business mailing address

5731 65TH ST
MASPETH NY
11378-2824
US

V. Phone/Fax

Practice location:
  • Phone: 929-378-5005
  • Fax:
Mailing address:
  • Phone:
  • Fax:

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: KRYSTAL ORTIZ
Title or Position: OWNER
Credential:
Phone: 929-378-5005