Provider Demographics
NPI:1740882653
Name:METELKIN, KARINA (MHC)
Entity type:Individual
Prefix:MRS
First Name:KARINA
Middle Name:
Last Name:METELKIN
Suffix:
Gender:F
Credentials:MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:21 BREWSTER ST
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10304-2221
Mailing Address - Country:US
Mailing Address - Phone:646-734-5591
Mailing Address - Fax:
Practice Address - Street 1:38 WINTHROP PL
Practice Address - Street 2:
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10314-3043
Practice Address - Country:US
Practice Address - Phone:718-727-7077
Practice Address - Fax:718-727-7673
Is Sole Proprietor?:No
Enumeration Date:2020-11-16
Last Update Date:2021-09-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health