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MRS. LIZANDRA M PORTALATIN MA, LPC
NPI 1346862000
Counselor - Mental Health in Clark, NJ

Active since May 15, 2020PECOS Enrolled
100 WALNUT AVE STE 210, CLARK, NJ 07066(732) 454-7810 Get Directions Write a Review

NPPES record last updated: January 27, 2025. Verified against the NPPES registry weekly; last sync: November 01, 2026.

About Mrs. Lizandra M Portalatin Ma, Lpc NPPES

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

MRS. LIZANDRA M PORTALATIN MA, LPC (NPI 1346862000) is an individual mental health provider in Clark, New Jersey, licensed in New Jersey (37AC00529000) and active in the NPI registry since May 2020. She is enrolled in Medicare PECOS.

NPPES Registry Identity

NPI1346862000
Entity TypeIndividualFemale
Primary Taxonomy101YM0800X
Provider Legal NameMRS. LIZANDRA M PORTALATINCredential: MA, LPC
Location Address100 WALNUT AVE STE 210Clark, NJ 07066-1269
Mailing Address100 Walnut Ave Ste 210Clark, NJ 07066-1269 · (732) 454-7810
Phone(732) 454-7810
Sole ProprietorNo
Enumeration DateMay 15, 2020
Last NPPES UpdateJanuary 27, 2025
NPPES CertifiedJanuary 27, 2025
✔ NPI 1346862000 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 NJ · 37AC00529000
100 WALNUT AVE STE 210, Clark, NJ 07066
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Accepted Insurance

The full list of accepted plans is on the Insurance tab. Issuers include Anthem Blue Cross and Blue Shield, Oscar Health.Insurance ›

Medicare Participation & PECOS CMS

Medicare enrollment, assignment, billing reassignment, and ordering and referring status from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Mrs. Lizandra M Portalatin Ma, Lpc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Eligible to Order & Refer✔ Part B Labs & Imaging✔ Durable Medical Equipment– Home Health Agency– Power Mobility DevicesPer the CMS Ordering and Referring file. Eligibility means Medicare pays claims that this provider orders or refers for these categories.

Medicare Billing Reassignment

Medicare enrollment records show Lizandra Portalatin reassigns Medicare billing to 1 organization. The organization bills Medicare for the services this provider delivers there.

Grace Space Counseling LLC
Same address
Mental Health
100 WALNUT AVE STE 210
Clark, NJ 07066
  • Reassigned Medicare billing, New Jersey enrollment
NPI 1851119929 (732) 454-7810

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

Other Providers at the Same Location NPPES 14

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

MARISSA CORTINAS BCBA
Behavior Analyst
100 WALNUT AVE STE 210
CLARK, NJ 07066
Union County (908) 731-1490
KENOUZ KHALIL
Counselor (Mental Health)
100 WALNUT AVE STE 210
CLARK, NJ 07066
Union County (732) 454-7810
FOUNDATIONS AUTISM LLC
Behavior Analyst
100 WALNUT AVE STE 210
CLARK, NJ 07066
Union County (908) 731-1490
MS. ELIZA MAE TANGONAN APN-C, PMHNP-BC
Nurse Practitioner
100 WALNUT AVE STE 210
CLARK, NJ 07066
Union County (973) 620-2774
AFIYA ABEO COZIER LPC, ACS, LCADC, CCS
Counselor (Addiction (Substance Use Disorder))
100 WALNUT AVE STE 210
CLARK, NJ 07066
Union County (443) 631-4252
CINDY CONCEICAO BCBA
Behavior Analyst
100 WALNUT AVE STE 210
CLARK, NJ 07066
Union County (908) 336-1716
MICHELLE LORDELLO BCBA
Behavior Analyst
100 WALNUT AVE STE 210
CLARK, NJ 07066
Union County (908) 336-1716
DAVID S GOLDSTEIN M.D.
Internal Medicine (Pulmonary Disease)
100 WALNUT AVE STE 210
CLARK, NJ 07066
Union County (732) 226-7400

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 Lizandra Portalatin's NPI number?

The NPI number for Lizandra Portalatin is 1346862000. It was assigned to this individual provider in the NPPES registry on May 15, 2020.

Where is Lizandra Portalatin located?

Lizandra Portalatin practices at 100 Walnut Ave Ste 210, Clark, NJ 07066. The listed phone number is (732) 454-7810.

What is Lizandra Portalatin's specialty?

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

Is Lizandra Portalatin enrolled in Medicare?

Yes. Lizandra Portalatin is registered in the Medicare PECOS enrollment system.

Which organization bills Medicare for Lizandra Portalatin's services?

According to the CMS Revalidation Reassignment List (October 2026 release), Lizandra Portalatin reassigns Medicare benefits to Grace Space Counseling LLC (Clark, NJ). The reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for Lizandra Portalatin's services. Reassignment records can lag staffing changes; confirm current arrangements with the organization.

What insurance does Lizandra Portalatin accept?

Health plans from Anthem Blue Cross and Blue Shield and Oscar Health list Lizandra Portalatin as in-network in at least one marketplace plan. Coverage varies by plan and year; verify with the insurer or the provider before a visit.

When was this NPI record last updated?

The NPPES record for Lizandra Portalatin was last updated on January 27, 2025. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 21 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.