Residential Psychotherapies,CSW,PC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R26799 Issued in NY

Legal business name

RESIDENTIAL PSYCHOTHERAPIES,CSW,PC

Practice address

42 Old Northport Rd.
Kings Park, NY 11754

Phone

(631) 366-0417

NPI assigned

Jul 13, 2006

Last updated

Apr 11, 2014By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Mr. Richard Nemiroff, LCSW

Title

Ceo

Phone

(631) 366-0417

Specialties & licenses 2

Addresses

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

{
    "created_epoch": "1152748800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1397174400000",
    "number": "1063437911",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "42 OLD NORTHPORT RD.",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "11754",
            "telephone_number": "631-366-0417"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "42 OLD NORTHPORT RD.",
            "city": "KINGS PARK",
            "state": "NY",
            "postal_code": "11754",
            "telephone_number": "631-366-0417"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "RESIDENTIAL PSYCHOTHERAPIES,CSW,PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-07-13",
        "last_updated": "2014-04-11",
        "status": "A",
        "authorized_official_last_name": "NEMIROFF",
        "authorized_official_first_name": "RICHARD",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "631-366-0417",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "RO26799",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R26799",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mark Francis Przebowski, R.N.
• Rachel Lynn Cunningham LMSW PC
• Gregory John Rahn, P.T.
• David Marc Rahr, DDS
• Stephen Bradley Ravitz, DPM
• Vanessa Rivera, RN
• Beth Holly Rizopoulos
• Paraskevi Roussos, CCC-SLP
• Helena D Rowe, LPN
• Sandra Ruggiero, LCSW

• Clinical Social Worker in Kings Park, NY
• Providers in Kings Park, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2014; 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.