Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.
MR. KEVIN MICHAEL WADALAVAGE, L.M.H.C.
Active Sole ProprietorAddiction (Substance Use Disorder) Counselor · FOREST HILLS, NY
Registration Details
- NPI Number
- 1629088117
- Provider Type
- Individual
- Gender
- Male
- NPI Issued
- Aug 8, 2006 (19.711483153844 yrs)
- Last Updated
- Sep 11, 2025
- Licenses
-
2421 (NY)2140 (NY)
- Sole Proprietor
- Yes
Practice Information
- Address
-
184 BURNS STFOREST HILLS, NY, 113756128Browse NY providers · Browse ZIP 11375
- Phone
- 7185200124
- Primary Specialty
-
Addiction (Substance Use Disorder) Counselor
101YA0400X
- Additional Specialty
- Mental Health Counselor
Other Addiction (Substance Use Disorder) Counselor Providers in FOREST HILLS, NY
| Name | Credential | NPI |
|---|---|---|
| KATE RUBY-SACHS | — | 1104114685 |
| GABRIEL ANDERSON | CASAC | 1376894899 |
| HEATHER E GORDON | LMHC | 1689111775 |
| DARIUS DOUGLAS | CASAC 2 21849 | 1831744945 |
| JESSE GROSS | — | 1528606571 |
| IRYNA KORIAEVA | — | 1902429723 |
Data sourced from the NPPES National Provider Identifier registry. This information is for informational purposes only and is not a substitute for verifying credentials with the appropriate licensing authority. For official verification, use the NPPES NPI Registry or the relevant state medical board.