Organization Active NPI

Letitia O. Brown LCSW, P.C.

  • Community/Behavioral Health Agency
  • West Islip, NY
National Provider Identifier
1104321116
Registry record updated Mar 30, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
079892 Issued in NY
Legal business name
LETITIA O. BROWN LCSW, P.C.
Practice address
631 Montauk Hwy Ste 5
West Islip, NY 11795-4400
Phone
(516) 761-0523
Fax
(631) 588-1343
NPI assigned
Mar 30, 2018
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Mar 30, 2018

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

Authorized official

Name
Letitia Olivia Brown, LCSWNPI 1356422802
Title
President
Phone
(516) 761-0523

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 079892 NY Primary

Addresses

Primary practice location

631 Montauk Hwy Ste 5
West Islip, NY 11795-4400

Mailing address

631 Montauk Hwy Ste 5
West Islip, NY 11795-4400
Phone (516) 761-0523

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20180423000097 NY Part B Supplier - Clinic/Group Practice 5496018640 Receives reassigned benefits from 1 practitioner
Practice locations: West Islip, NY

National Provider Directory

National Provider Directory

Locations

631 Montauk Hwy
Ste 5
West Islip, NY 11795
Phone (516) 761-0523

Practitioners & affiliated clinicians

Practitioners 1

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

NPI Registry JSON

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

{
    "created_epoch": "1522368000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1522368000000",
    "number": "1104321116",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "631 MONTAUK HWY STE 5",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954400",
            "telephone_number": "516-761-0523",
            "fax_number": "631-588-1343"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "631 MONTAUK HWY STE 5",
            "city": "WEST ISLIP",
            "state": "NY",
            "postal_code": "117954400",
            "telephone_number": "516-761-0523",
            "fax_number": "631-588-1343"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LETITIA O. BROWN LCSW, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-03-30",
        "last_updated": "2018-03-30",
        "status": "A",
        "authorized_official_last_name": "BROWN",
        "authorized_official_first_name": "LETITIA",
        "authorized_official_middle_name": "OLIVIA",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-761-0523",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": "079892",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in West Islip, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 30, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.