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KIMBERLY VELAZQUEZ MA, LMHC
NPI 1336915313
Counselor - Mental Health in East Islip, NY

Active since November 30, 2023Opted out of Medicare · through Nov 12, 2026
28 SIMMONS DR, EAST ISLIP, NY 11730(516) 256-9304 Get Directions Write a Review

NPPES record last updated: October 6, 2025. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Kimberly Velazquez Ma, Lmhc NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KIMBERLY VELAZQUEZ MA, LMHC (NPI 1336915313) is an individual mental health provider in East Islip, New York, licensed in New York (013980) and active in the NPI registry since November 2023. She has opted out of Medicare through November 12, 2026.

NPPES Registry Identity

NPI1336915313
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameKIMBERLY VELAZQUEZCredential: MA, LMHC
Location Address28 SIMMONS DREast Islip, NY 11730-2831
Mailing Address28 Simmons DrEast Islip, NY 11730-2831
Phone(516) 256-9304
Sole ProprietorYes
Enumeration DateNovember 30, 2023
Last NPPES UpdateOctober 6, 2025
NPPES CertifiedOctober 6, 2025
✔ NPI 1336915313 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Mental HealthBehavioral Health & Social Service Providers
Taxonomy Code101YM0800X
License✔ Licensed in NY · 013980
28 SIMMONS DR, East Islip, NY 11730
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Medicare Participation & PECOS CMS

Medicare enrollment, assignment, and ordering and referring status from the CMS PECOS system.

Medicare Enrollment Status

ⓘ

Opted out of Medicare

Kimberly Velazquez Ma, Lmhc has filed a Medicare opt-out affidavit. Services are provided under private contract between the provider and the patient, and are not billed to or reimbursed by Medicare. The opt-out is on file from November 12, 2024 through November 12, 2026.

Opt-Out Effective DateNovember 12, 2024
Opt-Out In Effect ThroughNovember 12, 2026Opt-out affidavits renew automatically every two years unless cancelled

Other Providers at the Same Location NPPES

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

DANIELLE JOSEPHINE NATALE LMHC
Counselor (Mental Health)
28 SIMMONS DR
EAST ISLIP, NY 11730
Suffolk County (631) 559-7155

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Kimberly Velazquez's NPI number?

The NPI number for Kimberly Velazquez is 1336915313. It was assigned to this individual provider in the NPPES registry on November 30, 2023.

Where is Kimberly Velazquez located?

Kimberly Velazquez practices at 28 Simmons Dr, East Islip, NY 11730. The listed phone number is (516) 256-9304.

What is Kimberly Velazquez's specialty?

The primary specialty registered for this NPI is Counselor, specializing in Mental Health, with taxonomy code 101YM0800X.

Is Kimberly Velazquez enrolled in Medicare?

No. Kimberly Velazquez has opted out of Medicare through November 12, 2026. Care is provided under private contracts, and Medicare does not pay for services furnished by providers who have opted out.

When was this NPI record last updated?

The NPPES record for Kimberly Velazquez was last updated on October 6, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 10 months ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.