Integrated Psychotherapy Counseling LCSW, PLLC

Primary specialty

Adult Mental Health Clinic/CenterTaxonomy code 261QM0850X

Legal business name

INTEGRATED PSYCHOTHERAPY COUNSELING LCSW, PLLC

Practice address

100 Mariners Way
Port Jefferson, NY 11777-1848

Phone

(934) 246-6042

NPI assigned

May 24, 2025

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Julie Stark, LCSWNPI 1790164812

Title

Clinician & Partner

Phone

(934) 246-6042

Specialties & licenses 1

Addresses

Other names 1

• Root & Rise Clinical Specialists Doing business as

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Julie L. Stark, MSW, LCSW

  • Clinical Social Worker
  • Boca Raton, FL
  • NPI 1790164812
  NPD Authorized official

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1748044800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1762300800000",
    "number": "1003609827",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 MARINERS WAY",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771848",
            "telephone_number": "934-246-6042",
            "fax_number": "631-201-7390"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 MARINERS WAY",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771848",
            "telephone_number": "934-246-6042"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "646 Main St Ste 102",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson",
            "state": "NY",
            "postal_code": "117772230",
            "country_code": "US",
            "telephone_number": "934-246-6042",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "5301 N Federal Hwy Ste 380",
            "address_purpose": "LOCATION",
            "city": "Boca Raton",
            "state": "FL",
            "postal_code": "334874916",
            "country_code": "US",
            "telephone_number": "934-246-6042",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "INTEGRATED PSYCHOTHERAPY COUNSELING LCSW, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-05-24",
        "last_updated": "2025-11-05",
        "certification_date": "2025-11-05",
        "status": "A",
        "authorized_official_last_name": "STARK",
        "authorized_official_first_name": "JULIE",
        "authorized_official_title_or_position": "CLINICIAN & PARTNER",
        "authorized_official_telephone_number": "934-246-6042",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261QM0850X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Adult Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "Root & Rise Clinical Specialists",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

• Amenah Ibrahim, DO
• Kirolos Ibrahim, M.D.
• Roseline Idoko
• Becca Ilvento, PSY.D.
• Iryna Ilyasova, M.D
• Island Emergency Medical Services PC
• Island Neonatology, PLLC
• Island Psychiatry, P.C.
• Lauren L Jackson, DPT
• Jan S. Miller

• Adult Mental Health Clinic/Center in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• Adult Mental Health Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 5, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.