Self Initiated Living Options Inc

Primary specialty

Community/Behavioral Health AgencyTaxonomy code 251S00000X

Legal business name

SELF INITIATED LIVING OPTIONS INC

Practice address

3253 Route 112 BLDG 10
Medford, NY 11763-1411

Phone

(631) 880-7929

Fax

(631) 946-6377

NPI assigned

May 13, 2021

Organization subpart

No

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

Authorized official

Name

Mr. Joseph Delgado

Title

Chief Executive Officer

Phone

(631) 880-7929

Specialties & licenses 1

Addresses

Locations

Practitioners 4

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

• Brianna Albano-Niedzwieski

  • Clinical Social Worker
  • Medford, NY
  • NPI 1669147971
  NPD
• Lisa Corleto

  • Clinical Social Worker
  • Jamaica, NY
  • NPI 1720578644
  NPD
• Ecaterina Henter, LMSW

  • Social Worker
  • Medford, NY
  • NPI 1154003598
  NPD
• John Karahalis

  • School Psychologist
  • Medford, NY
  • NPI 1114675923
  NPD

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

{
    "created_epoch": "1620864000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1629763200000",
    "number": "1215501424",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3253 ROUTE 112 BLDG 10",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117631411",
            "telephone_number": "631-880-7929",
            "fax_number": "631-946-6377"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3253 ROUTE 112 BLDG 10",
            "city": "MEDFORD",
            "state": "NY",
            "postal_code": "117631411",
            "telephone_number": "631-880-7929",
            "fax_number": "631-946-6377"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SELF INITIATED LIVING OPTIONS INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-05-13",
        "last_updated": "2021-08-24",
        "certification_date": "2021-08-10",
        "status": "A",
        "authorized_official_last_name": "DELGADO",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "CHIEF EXECUTIVE OFFICER",
        "authorized_official_telephone_number": "631-880-7929",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "251S00000X",
            "taxonomy_group": "",
            "desc": "Community/Behavioral Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Monica Lorraine Schlie, LCSW
• Christie Lyn Schrank-Krupa, MS, BCBA, LBA
• Lena Scotti
• Abby Sear, LCSW
• Roon Sebastian, LMSW
• Self Initiated Living Options Inc
• Seniorbridge Family Companies (Ny), Inc
• Rhiannon Skye Sgambati
• Badrud D Shaikh
• Jaclyn Kristin Shea

• Community/Behavioral Health Agency in Medford, NY
• Providers in Medford, 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 Aug 24, 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.