Provider Demographics
NPI:1063746436
Name:PORINCHAK, MARIA (LMHC (NY), LPCC (NM))
Entity type:Individual
Prefix:
First Name:MARIA
Middle Name:
Last Name:PORINCHAK
Suffix:
Gender:F
Credentials:LMHC (NY), LPCC (NM)
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:206 EDITH BLVD NE
Mailing Address - Street 2:
Mailing Address - City:ALBUQUERQUE
Mailing Address - State:NM
Mailing Address - Zip Code:87102-3526
Mailing Address - Country:US
Mailing Address - Phone:202-344-6733
Mailing Address - Fax:
Practice Address - Street 1:3212 MONTE VISTA BLVD NE
Practice Address - Street 2:
Practice Address - City:ALBUQUERQUE
Practice Address - State:NM
Practice Address - Zip Code:87106-2120
Practice Address - Country:US
Practice Address - Phone:646-820-3740
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-10-01
Last Update Date:2025-02-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NMCTB-2022-0766101YP2500X
NY007820101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Provider Identifiers
StateIdentifier IDID TypeIssuer
NM71750274Medicaid