Organization Active NPI

Long Island Counseling LCSW PC

  • Clinical Social Worker
  • East Meadow, NY
National Provider Identifier
1366894750
Registry record updated May 15, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
056086R Issued in NY
Legal business name
LONG ISLAND COUNSELING LCSW PC
Practice address
2545 Hempstead Tpke Ste 105
East Meadow, NY 11554-2147
Phone
(516) 882-4544
NPI assigned
Jul 8, 2016
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 15, 2023

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

Authorized official

Name
Mrs. Stacy Leigh Pellettieri, LCSW
Title
Clinical Director
Phone
(516) 680-5967

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X 056086R NY Primary

Addresses

Primary practice location

2545 Hempstead Tpke Ste 105
East Meadow, NY 11554-2147

Mailing address

2255 Centre Ave Ste 2
Bellmore, NY 11710-3499
Phone (516) 882-4544

Other practice location 1

2255 Centre Ave Ste 2
Bellmore, NY 11710-3499
Phone (516) 882-4544

Other practice location 2

2116 Merrick Ave
Suite 3008
Merrick, NY 11566-3445
Phone (516) 680-5967

Medicare participation

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

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20190308000337 NY Part B Supplier - Clinic/Group Practice 7113266131 Receives reassigned benefits from 5 practitioners
Practice locations: East Meadow, NY; Rockville Centre, NY; Melville, NY; Huntington, NY

National Provider Directory

National Provider Directory

Locations

2255 Centre Ave
Ste 2
Bellmore, NY 11710
Phone (516) 882-4544

2545 Hempstead Tpke
Ste 105
East Meadow, NY 11554
Phone (347) 485-7414

150 Broadhollow Rd
Ste 310
Melville, NY 11747
Phone (516) 882-4544

100 N Centre Ave
Ste 204
Rockville Centre, NY 11570
Phone (516) 882-4544

Practitioners & affiliated clinicians

Practitioners 10

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": "1467936000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1684108800000",
    "number": "1366894750",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2255 CENTRE AVE STE 2",
            "city": "BELLMORE",
            "state": "NY",
            "postal_code": "117103499",
            "telephone_number": "516-882-4544",
            "fax_number": "631-206-9299"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "2545 HEMPSTEAD TPKE STE 105",
            "city": "EAST MEADOW",
            "state": "NY",
            "postal_code": "115542147",
            "telephone_number": "516-882-4544"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2255 Centre Ave Ste 2",
            "address_purpose": "LOCATION",
            "city": "Bellmore",
            "state": "NY",
            "postal_code": "117103499",
            "country_code": "US",
            "telephone_number": "516-882-4544",
            "fax_number": "631-206-9299",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2116 Merrick Ave",
            "address_2": "Suite 3008",
            "address_purpose": "LOCATION",
            "city": "Merrick",
            "state": "NY",
            "postal_code": "115663445",
            "country_code": "US",
            "telephone_number": "516-680-5967",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "LONG ISLAND COUNSELING LCSW PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2016-07-08",
        "last_updated": "2023-05-15",
        "certification_date": "2023-05-15",
        "status": "A",
        "authorized_official_last_name": "PELLETTIERI",
        "authorized_official_first_name": "STACY",
        "authorized_official_middle_name": "LEIGH",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "516-680-5967",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "056086R",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Meadow, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 15, 2023; 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.