The Way Back, Inc.

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

THE WAY BACK, INC.

Practice address

1401 Main St
Port Jefferson, NY 11777-2225

Phone

(631) 928-0202

Fax

(631) 928-4385

NPI assigned

Jul 5, 2007

Organization subpart

No

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

Authorized official

Name

Mr. Francis X. Burke

Title

Executive Director

Phone

(631) 928-0202

Specialties & licenses 1

Addresses

Locations

Practitioners 3

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

• Monica Massaro, LCSW

  • Clinical Social Worker
  • Port Jefferson, NY
  • NPI 1598396970
  NPD (past)
• Ryan J McGurk, LMHC

  • Mental Health Counselor
  • Port Jefferson, NY
  • NPI 1659886687
  NPD (past)
• Kathleen A Tyler, LCSW

  • Clinical Social Worker
  • Port Jefferson, NY
  • NPI 1912538638
  NPD (past)

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

{
    "created_epoch": "1183593600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1658361600000",
    "number": "1205034857",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1401 MAIN ST",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772225",
            "telephone_number": "631-928-0202",
            "fax_number": "631-928-4385"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1401 MAIN ST",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117772225",
            "telephone_number": "631-928-0202",
            "fax_number": "631-928-4385"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE WAY BACK, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-07-05",
        "last_updated": "2022-07-21",
        "status": "A",
        "authorized_official_last_name": "BURKE",
        "authorized_official_first_name": "FRANCIS",
        "authorized_official_middle_name": "X.",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "631-928-0202",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kim M. Tassinari, PH.D.
• Bonnie Taub, LMT
• Michael Kenneth Tax, LPN
• Lisa Taxman Goldfarb, PH.D.
• The Community Programs Center of L.I. (Day Haven Adult Day Services)
• Dinushan Thirumavalavan, D.O.
• Elizabeth Ann Thomas-Lov, P.T.
• Christina Thompson, PA
• Petrel Thompson
• Three Village Medicine PC

• Community/Behavioral Health Agency in Port Jefferson, NY
• Providers in Port Jefferson, NY by specialty
• Community/Behavioral Health Agency in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 21, 2022; 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.