MEDICARE: MARIA PORINCHAK LMHC (NY), LPCC (NM)

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	101YP2500X	Professional Counselor	CTB-2022-0766	NM
2	101YM0800X	Mental Health Counselor	007820	NY

Other Identifiers

#	Provider Identifier	Provider Identifier Type	Provider Identifier State	Provider Identifier Issuer
1	MEDICAID ID Found: Get Medicaid Details using Online Medicaid Verification Program

General Provider Information

NPI Number	:	1063746436
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	MARIA PORINCHAK LMHC (NY), LPCC (NM)

Provider Business Mailing Address
First Line	:	206 EDITH BLVD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87102-3526
Country	:	US
Telephone Number	:	202-344-6733
Fax Number	:

Provider Business Practice Location Address
First Line	:	3212 MONTE VISTA BLVD NE
Second Line	:
City	:	ALBUQUERQUE
State	:	NM
Zip	:	87106-2120
Country	:	US
Telephone Number	:	646-820-3740
Fax Number	:

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

Provider Enumeration Date	:	10/01/2009
Last Update Date	:	02/03/2025

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Directions to “ MARIA PORINCHAK LMHC (NY), LPCC (NM)” Practice Location

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