Active NPI
Family Care Counseling Services, LCSW,P.C.
- Clinical Social Worker
- Miller Place, NY
National Provider Identifier
1467578575
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- R040232
- Legal business name
- FAMILY CARE COUNSELING SERVICES, LCSW,P.C.
- Practice address
- 595 Route 25a Ste 20
Miller Place, NY 11764-2647 - Phone
- (631) 744-5500
- Fax
- (631) 744-5677
- NPI assigned
- Mar 21, 2007
- Organization subpart
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Authorized official
- Name
- Mrs. Kathleen Anne Van Essendelft, L-RCSW
- Title
- Director
- Phone
- (631) 744-5500
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | R040232 | NY | Primary |
Addresses
Primary practice location
595 Route 25a Ste 20
Miller Place, NY 11764-2647
Mailing address
595 Route 25a Ste 20
Miller Place, NY 11764-2647
Phone (631) 744-5500
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Enrolled in NY
Enrollment records 1
National Provider Directory
National Provider DirectoryLocations
595 Route 25A
Ste 20
Miller Place, NY 11764
Phone (631) 744-5500
Practitioners & affiliated clinicians
Practitioners 5
Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.
-
- Clinical Social Worker
- Miller Place, NY
- NPI 1821134578
-
- Mental Health Counselor
- Miller Place, NY
- NPI 1942642046
-
- Mental Health Counselor
- Miller Place, NY
- NPI 1275726481
-
- Mental Health Counselor
- Miller Place, NY
- NPI 1235397266
-
- Social Worker
- Miller Place, NY
- NPI 1235336496
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1174435200000",
"enumeration_type": "NPI-2",
"last_updated_epoch": "1199750400000",
"number": "1467578575",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "595 ROUTE 25A STE 20",
"city": "MILLER PLACE",
"state": "NY",
"postal_code": "117642647",
"telephone_number": "631-744-5500",
"fax_number": "631-744-5677"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "595 ROUTE 25A STE 20",
"city": "MILLER PLACE",
"state": "NY",
"postal_code": "117642647",
"telephone_number": "631-744-5500",
"fax_number": "631-744-5677"
}
],
"practiceLocations": [],
"basic": {
"organization_name": "FAMILY CARE COUNSELING SERVICES, LCSW,P.C.",
"organizational_subpart": "NO",
"enumeration_date": "2007-03-21",
"last_updated": "2008-01-08",
"status": "A",
"authorized_official_last_name": "VAN ESSENDELFT",
"authorized_official_first_name": "KATHLEEN",
"authorized_official_middle_name": "ANNE",
"authorized_official_title_or_position": "DIRECTOR",
"authorized_official_telephone_number": "631-744-5500",
"authorized_official_name_prefix": "Mrs.",
"authorized_official_credential": "L-RCSW"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "R040232",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Miller Place, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2008; 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.