Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Dr. Edwardo J Medina Jr., PHDTHD

Individual provider Mental Health Counselor · NPI 1437370137

Dr. Edwardo J Medina Jr., PHDTHD is a Mental Health Counselor in Staten Island, New York. Registered with an NPI since 2007.

In the registry since
2007
Specialties on file
3

Practice location Address checks out

800 Manor Rd #2V Professional Suites #2V
Staten Island, NY 10314-7016
Phone: (646) 266-4010
Fax: (718) 761-5562
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Mental Health Counselor (primary) Taxonomy 101YM0800X · Licence SW081981
Clinical Social Worker Taxonomy 1041C0700X · Licence SW081981
Marriage & Family Therapist Taxonomy 106H00000X · Licence SW081981

Record details

NPI number1437370137
Entity typeIndividual (Type 1)
GenderMale
Credentials PHDTHD
Sole proprietorNo
NPI enumeratedMay 1, 2007
Last updated in NPPESSeptember 11, 2025

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