NPIMap

Organization Active NPI

Changing Seasons Counseling LCSW PLLC

  • Clinical Social Worker
  • Port Jefferson Station, NY
National Provider Identifier
1316646607
Registry record updated Oct 1, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
CHANGING SEASONS COUNSELING LCSW PLLC
Practice address
425 Old Town Rd
Port Jefferson Station, NY 11776-3627
Phone
(631) 209-7042
NPI assigned
Feb 27, 2023
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 1, 2023

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

Authorized official

Name
Fernando Edgardo Beltran Jr., LCSWNPI 1164035200
Title
Clinical Social Worker
Phone
(631) 575-3435

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

425 Old Town Rd
Port Jefferson Station, NY 11776-3627

Mailing address

425 Old Town Rd
Port Jefferson Station, NY 11776-3627
Phone (631) 209-7042

National Provider Directory

National Provider Directory

Locations

425 Old Town Rd
Port Jefferson Station, NY 11776
Phone (631) 209-7042

Practitioners & affiliated clinicians

Practitioners 6

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

NPI Registry JSON

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

{
    "created_epoch": "1677456000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1696118400000",
    "number": "1316646607",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "425 OLD TOWN RD",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117763627",
            "telephone_number": "631-209-7042"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "425 OLD TOWN RD",
            "city": "PORT JEFFERSON STATION",
            "state": "NY",
            "postal_code": "117763627",
            "telephone_number": "631-209-7042"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "CHANGING SEASONS COUNSELING LCSW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-02-27",
        "last_updated": "2023-10-01",
        "certification_date": "2023-10-01",
        "status": "A",
        "authorized_official_last_name": "BELTRAN",
        "authorized_official_first_name": "FERNANDO",
        "authorized_official_middle_name": "EDGARDO",
        "authorized_official_title_or_position": "CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "631-575-3435",
        "authorized_official_name_suffix": "Jr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Port Jefferson Station, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2023; 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.