Live Well Psychotherapy LCSW PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

LIVE WELL PSYCHOTHERAPY LCSW PLLC

Practice address

100 Broadhollow Rd Ste 108
Farmingdale, NY 11735-4813

Phone

(631) 769-7763

Fax

(631) 769-7763

NPI assigned

Nov 3, 2021

Organization subpart

No

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

Authorized official

Name

Ms. Carmen R Ceballos, LCSW-RNPI 1972675874

Title

Owner/Psychotherapist

Phone

(631) 769-7763

Specialties & licenses 1

Addresses

Locations

Practitioners 1

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

• Carmen R Ceballos, LCSW-R

  • Clinical Social Worker
  • Farmingdale, NY
  • NPI 1972675874
  NPD Authorized official

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

{
    "created_epoch": "1635897600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1638748800000",
    "number": "1245995372",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "26 WILSON AVE",
            "city": "DEER PARK",
            "state": "NY",
            "postal_code": "117296714",
            "telephone_number": "646-932-6759",
            "fax_number": "631-769-7763"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 BROADHOLLOW RD STE 108",
            "city": "FARMINGDALE",
            "state": "NY",
            "postal_code": "117354813",
            "telephone_number": "631-769-7763",
            "fax_number": "631-769-7763"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "LIVE WELL PSYCHOTHERAPY LCSW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-03",
        "last_updated": "2021-12-06",
        "certification_date": "2021-12-06",
        "status": "A",
        "authorized_official_last_name": "CEBALLOS",
        "authorized_official_first_name": "CARMEN",
        "authorized_official_middle_name": "R",
        "authorized_official_title_or_position": "OWNER/PSYCHOTHERAPIST",
        "authorized_official_telephone_number": "631-769-7763",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW-R"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lilac Nutrition LLC
• Lincare Inc.
• Emily Linehan
• Susy Lino-Montes
• Live Love Laugh Mindfulness Nurse Practitioner in Psychiatry PLLC
• Rosemarie Liwanag-Schaefer, RN
• Linda M Lizo
• Barbara Llanto, LPN
• Richard David Llanton, LMHC
• Janet Lockie, D.C.

• Clinical Social Worker in Farmingdale, NY
• Providers in Farmingdale, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 6, 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.