Dylan Thomas Kluber, LMSW

Primary specialty

Social WorkerTaxonomy code 104100000X

License

112218 Issued in NY

Practice address

401 Main St Ste 108
Islip, NY 11751-3560

Phone

(631) 446-1950

Fax

(631) 446-1952

NPI assigned

Jun 30, 2021

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• West Islip Youth Enrichment Services Incorporated

  • Community/Behavioral Health Agency
  • Islip, NY
  • NPI 1306260096
  NPD (past)

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

{
    "created_epoch": "1625011200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1625011200000",
    "number": "1467022418",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9 BATES LN",
            "city": "RIDGE",
            "state": "NY",
            "postal_code": "119611726",
            "telephone_number": "631-603-5195"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "401 MAIN ST STE 108",
            "city": "ISLIP",
            "state": "NY",
            "postal_code": "117513560",
            "telephone_number": "631-446-1950",
            "fax_number": "631-446-1952"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KLUBER",
        "first_name": "DYLAN",
        "middle_name": "THOMAS",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2021-06-30",
        "last_updated": "2021-06-30",
        "certification_date": "2021-06-30",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "112218",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Nora M Kiesel-Klaus
• Mary Elizabeth Killeen-McDermott, M.A., CCC, SLP
• Kiran Trivedi DO PLLC
• Karen Lynn Kirchner
• Sarah Catherine Klein
• Yarmila Kocisova, LMT
• Mary J Korpacz Fink, D.O.
• Elissa H Kravis, ANP
• Rebecca Lynn Kristiansen
• Lori Kulynych

• Social Worker in Islip, NY
• Providers in Islip, NY by specialty
• Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 30, 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.