MEDICARE: INNER MIND JOURNEY MENTAL HEALTH COUNSELING, PLLC

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	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1962381251
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	INNER MIND JOURNEY MENTAL HEALTH COUNSELING, PLLC

Provider Business Mailing Address
First Line	:	238 WILSON AVE # B120
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11237-8019
Country	:	US
Telephone Number	:	646-389-5136
Fax Number	:	646-389-5136

Provider Business Practice Location Address
First Line	:	270 WILSON AVE APT 2A
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11237-5153
Country	:	US
Telephone Number	:	347-743-6066
Fax Number	:

Authorized Official
Title or Position	:	OWNER
Name	:	MS. EUNICE SANTIAGO
Credential	:	LMHC
Telephone Number	:	347-743-6066

Provider Enumeration Date	:	08/29/2025
Last Update Date	:	08/29/2025

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