Theodora Slone LCSW LLC

Primary specialty

Clinic/CenterTaxonomy code 261Q00000X

Legal business name

THEODORA SLONE LCSW LLC

Practice address

185 Davenport St
Lindenhurst, NY 11757-5317

Phone

(631) 827-2813

NPI assigned

Oct 26, 2021

Last updated

Oct 26, 2021By 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

Theodora Rush Slone, LCSWNPI 1346762994

Title

Therapist/ Owner

Phone

(631) 827-2813

Specialties & licenses 1

Addresses

Other identifiers 1

Electronic endpoints 1

Practitioners 1

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.

• Theodora Rush Slone, LCSW

  • Social Worker
  • Methuen, MA
  • NPI 1346762994
  NPD Authorized official

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

{
    "created_epoch": "1635206400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1635206400000",
    "number": "1174287130",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "185 DAVENPORT ST",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117575317",
            "telephone_number": "631-827-2813"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "185 DAVENPORT ST",
            "city": "LINDENHURST",
            "state": "NY",
            "postal_code": "117575317",
            "telephone_number": "631-827-2813"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THEODORA SLONE LCSW LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-10-26",
        "last_updated": "2021-10-26",
        "certification_date": "2021-10-26",
        "status": "A",
        "authorized_official_last_name": "SLONE",
        "authorized_official_first_name": "THEODORA",
        "authorized_official_middle_name": "RUSH",
        "authorized_official_title_or_position": "THERAPIST/ OWNER",
        "authorized_official_telephone_number": "631-827-2813",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "261Q00000X",
            "taxonomy_group": "",
            "desc": "Clinic/Center",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "06711600",
            "state": "NY"
        }
    ],
    "endpoints": [
        {
            "endpointType": "CONNECT",
            "endpointTypeDescription": "CONNECT URL",
            "endpoint": "simplepractice",
            "affiliation": "N",
            "endpointDescription": "EHR system",
            "address_1": "185 Davenport St",
            "city": "Lindenhurst",
            "state": "NY",
            "country_code": "US",
            "postal_code": "117575317",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

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• Yanick Thermidor, LPN
• Annmarie Claire Thomas
• Jennifer Timque, JENNIFER TIMQUE
• Seth Thomas Tiringer, OTR/L

• Clinic/Center in Lindenhurst, NY
• Providers in Lindenhurst, NY by specialty
• Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 26, 2021; 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.