NPIMap

Organization Active NPI

Clinical Care Associates, P.C.

  • Community/Behavioral Health Agency
  • Holbrook, NY
National Provider Identifier
1144674359
Registry record updated Apr 14, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Community/Behavioral Health AgencyTaxonomy code 251S00000X
License
73047593 Issued in NY
Legal business name
CLINICAL CARE ASSOCIATES, P.C.
Practice address
20 Peachtree CT
Suite 100
Holbrook, NY 11741-4616
Phone
(631) 475-8641
NPI assigned
Apr 14, 2016
Last updated
Apr 14, 2016By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Apr 14, 2016

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

Authorized official

Name
Pablo Guevara, LCSWNPI 1457618712
Title
Director
Phone
(631) 289-5353

Authorized official NPPES reports the official by name only. The link goes to the one practitioner with that name whose NPPES practice address or phone number is this organization’s.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Community/Behavioral Health Agency 251S00000X 73047593 NY Primary

Addresses

Primary practice location

20 Peachtree CT
Suite 100
Holbrook, NY 11741-4616

Mailing address

20 Peachtree CT
Suite 100
Holbrook, NY 11741-4616

National Provider Directory

National Provider Directory

Locations

20 Peachtree Ct
Ste 100
Holbrook, NY 11741
Phone (631) 475-8641

Practitioners & affiliated clinicians

Practitioners 2

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

NPI Registry JSON

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

{
    "created_epoch": "1460592000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1460592000000",
    "number": "1144674359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "20 PEACHTREE CT",
            "address_2": "SUITE 100",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117414616"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "20 PEACHTREE CT",
            "address_2": "SUITE 100",
            "city": "HOLBROOK",
            "state": "NY",
            "postal_code": "117414616",
            "telephone_number": "631-475-8641"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CLINICAL CARE ASSOCIATES, P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-04-14",
        "last_updated": "2016-04-14",
        "status": "A",
        "authorized_official_last_name": "GUEVARA",
        "authorized_official_first_name": "PABLO",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "631-289-5353",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": "73047593",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Holbrook, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 14, 2016; 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.