OrganizationActive
Mariya Yakutilova
NPI 1962812958 · Community/Behavioral Health Agency · Forest Hills, NY
Provider details
- NPI number
- 1962812958
- Entity type
- Organization
- Primary specialty
- Community/Behavioral Health AgencyAgencies
- Organization subpart
- No
- Authorized official
- Mariya Yakutilova, Cota(646) 402-4543
- License
- 007061 (NY)
Specialties & taxonomies
Agencies
Profile Score
Detailed profile(76/100 index)
A profile completeness & documented-activity index — NOT a quality, outcomes, or patient-satisfaction rating.
- Registry tenure38% of score
12 yrs in NPPES registry
- Profile completeness38% of score
100% of core fields populated
- Practice footprint23% of score
1 documented practice location
Signals a provider has no public data for (e.g. Medicare claims) are left out of the score entirely — never counted as zero — so providers without that data are not penalized. See the full formula and weights in our methodology.
Practice location
10812 72nd Ave
Forest Hills, NY 11375-7079
Phone: (646) 402-4543
Street-level locationGet directions
Mailing address
9823 Horace Harding Expy Apt 6e
Corona, NY 11368-4258
Registry dates
- Enumerated
- 2014-04-30
- Last updated
- 2014-04-30
Source: CMS NPPES Data Dissemination (June 2026). NPI Central is not affiliated with CMS. Data is provided as-is from the public registry.