NPIMap

Organization Active NPI

Suffolk Family Therapy LCSW P.C.

  • Clinical Social Worker
  • Bohemia, NY
National Provider Identifier
1356977177
Registry record updated Oct 23, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SUFFOLK FAMILY THERAPY LCSW P.C.
Practice address
4109 Sunrise Hwy
Bohemia, NY 11716-4600
Phone
(631) 503-1539
NPI assigned
Mar 13, 2020
Last updated
Oct 23, 2026By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Oct 23, 2026

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

Authorized official

Name
Jamie Vollmoeller, LCSWNPI 1720432032
Title
Ceo
Phone
(631) 503-1539

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 Worker 1041C0700X NU Primary

Addresses

Primary practice location

4109 Sunrise Hwy
Bohemia, NY 11716-4600

Mailing address

4109 Sunrise Hwy
Bohemia, NY 11716-4600
Phone (631) 503-1539

Other practice location 1

732 Smithtown Byp Ste A52
Smithtown, NY 11787-5020
Phone (631) 503-1539

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20250421001425 NY Part B Supplier - Clinic/Group Practice 1951826122 Receives reassigned benefits from 4 practitioners
Practice locations: Smithtown, NY; Bohemia, NY

National Provider Directory

National Provider Directory

Locations

4109 Sunrise Hwy
Bohemia, NY 11716
Phone (631) 384-6831

606 Johnson Ave
Ste 34
Bohemia, NY 11716
Phone (631) 503-1539

732 Smithtown Byp
Ste A52
Smithtown, NY 11787
Phone (631) 503-1539

Practitioners & affiliated clinicians

Practitioners 15

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

View all 15

NPI Registry JSON

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

{
    "created_epoch": "1584057600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1792713600000",
    "number": "1356977177",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "4109 SUNRISE HWY",
            "city": "BOHEMIA",
            "state": "NY",
            "postal_code": "117164600",
            "telephone_number": "631-503-1539"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4109 SUNRISE HWY",
            "city": "BOHEMIA",
            "state": "NY",
            "postal_code": "117164600",
            "telephone_number": "631-503-1539"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "732 Smithtown Byp Ste A52",
            "address_purpose": "LOCATION",
            "city": "Smithtown",
            "state": "NY",
            "postal_code": "117875020",
            "country_code": "US",
            "telephone_number": "631-503-1539",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SUFFOLK FAMILY THERAPY LCSW P.C.",
        "organizational_subpart": "NO",
        "enumeration_date": "2020-03-13",
        "last_updated": "2026-10-23",
        "certification_date": "2026-10-23",
        "status": "A",
        "authorized_official_last_name": "VOLLMOELLER",
        "authorized_official_first_name": "JAMIE",
        "authorized_official_title_or_position": "CEO",
        "authorized_official_telephone_number": "631-503-1539",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bohemia, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 23, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.