Provider Type Icon

SOUTHSHORE COUNSELING MEDIATION AND LICENSED CLINICAL SOCIAL WORK SERV NPI 1366684078


NPI Information

NPI: 1366684078
Provider Name: SOUTHSHORE COUNSELING MEDIATION AND LICENSED CLINICAL SOCIAL WORK SERV
Classification: Social Worker - 1041C0700X
Entity Type: Organization

Specialization: Clinical

Address:
36 EDGAR AVE
BROOKHAVEN, NY
ZIP 11719
Phone: (631) 286-8282
Get Directions

SOUTHSHORE COUNSELING MEDIATION AND LICENSED CLINICAL SOCIAL WORK SERV is a clinical social worker in Brookhaven, NY. The provider is a social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances. SOUTHSHORE COUNSELING MEDIATION AND LICENSED CLINICAL SOCIAL WORK SERV NPI is 1366684078. The provider is registered as an organization entity type and is a single specialty group.

The provider's business location address is:

36 EDGAR AVE
BROOKHAVEN, NY
ZIP 11719-655
Phone: (631) 286-8282
Fax: (631) 803-6793

The provider's authorized official is Michelle Cavaleri .
The authorized official title is Executive Officer and has the following contact phone number (631) 286-8282.

The enumeration date for this NPI number is 3/26/2009 and was last updated on 4/15/2016.


Taxonomy Codes

The NPI record includes the healthcare provider taxonomy classification, state license number and state of licensure. The following information regarding the scope of practice of this provider is available:

No.Taxonomy CodeTaxonomy ClasificationTaxonomy SpecializationLicense NumberLicense StatePrimary
11041C0700XSocial WorkerClinical075548-1NEW YORKYes

What is NPI?

NPI stands for National Provider Identifier. The NPI is a 10-digit identification number that is completely unique. The NPI number by itself does not contain any identifiable information such as a provider’s speciality or location. The NPI is assigned to individuals or organizacions for their lifespan and it is independent of key provider information type updates like a change of practices, location or speciality.

This page was last updated on: 4/28/2024

All materials and services on this site are provided on an "as is" and "as available" basis without warranty of any kind. The NPI record is maintained by the National Plan & Provider Enumeration System (NPPES) and anyone may request this information and other NPPES health care provider data from HHS under The Freedom of Information Act (FOIA), Title 5 of the United States Code, section 552. To update the NPI records please contact the NPPES.