Justina Coll, LCSW
Individual provider Active NPI Marriage & Family Therapist · Centereach, NY
NPI 1306024682 · NPPES record last updated Feb 8, 2008
Key facts
- NPI
- 1306024682
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Marriage & Family Therapist 106H00000X
- License
- RO38170 (NY)
- Practice address
- 1 Leonard LN
Centereach, NY 11720-2753 - Phone
- (631) 471-7301
- Fax
- (631) 979-5867
- NPI assigned
- Feb 8, 2008
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare Care Compare profile
- Specialty
- Clinical Social Worker
- Education
- Other, 1983
- Medicare assignment
- Accepts the Medicare-approved amount as payment in full
- Group practices
- Dawn Friedland-Perez LCSW,PC
Practice addresses (Care Compare)
12 Woodstork Dr
Mt. Sinai, NY 11766-3400
Phone (631) 736-7707
Medicare participation
- Medicare fee-for-service enrollment
- Enrolled in NY
- Eligible to order & refer
- Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No
Medicare enrollment records
| Enrollment ID | State | Provider type | PAC ID | Details |
|---|---|---|---|---|
| I20130806000021 | NY | Practitioner - Clinical Social Worker | 5991947897 | Reassigns benefits to 1 organization |
National Provider Directory
- Medicare enrollment (NPD)
- Yes
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| RO38170 | NY | MD | Marriage & Family Therapist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Dawn Friedland-Perez, LCSW, P.C. | Current |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Marriage & Family Therapist | 106H00000X | RO38170 | NY | Yes |
Addresses
Primary practice location
1 Leonard LN
Centereach, NY 11720-2753
Mailing address
1 Leonard LN
Centereach, NY 11720-2753
Phone (631) 471-7301
Other providers in Centereach, NY
- Emily Chiominto
- Cinquemani & Leibowitz DDS
- Sara C Cioffi
- Carissa Lynn Citro
- Eunice V Clarke
- Community Medical Care of Centereach, P.C.
- Carleen Conde
- Allison Connors-Wesch
- Lisa A Cooper
- Jeanine Coppola
All providers in Centereach, NY · Marriage & Family Therapist in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Feb 8, 2008. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- Medicare Fee-For-Service Public Provider Enrollment (CMS/PECOS): enrollments, PAC IDs and benefit reassignments.
- Order and Referring (CMS).
- Medicare Care Compare provider data (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.