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NPI Code Detail

MEDICARE: DORINDA J ROGERS MADERA LMHC

MEDICARE: DORINDA J ROGERS MADERA LMHC
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
1390200000XStudent in an Organized Health Care Education/Training Program
2101YM0800XMental Health Counselor

General Provider Information

NPI Number : 1710500707
Entity Type Code : Individual
Provider Name (Legal Business Name) : DORINDA J ROGERS MADERA LMHC
Provider Business Mailing Address
First Line : 17561 HILLSIDE AVE STE
Second Line :
City : JAMAICA
State : NY
Zip : 11432-5771
Country : US
Telephone Number : 929-639-0278
Fax Number : 646-846-8532
Provider Business Practice Location Address
First Line : 17561 HILLSIDE AVE STE 202
Second Line :
City : JAMAICA
State : NY
Zip : 11432-5771
Country : US
Telephone Number : 929-639-0278
Fax Number : 646-846-8532
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 05/25/2020
Last Update Date : 03/11/2026

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