Soaring Feathers Licensed Clinical Social Work PLLC

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

Legal business name

SOARING FEATHERS LICENSED CLINICAL SOCIAL WORK PLLC

Practice address

335 N Dunton Ave
East Patchogue, NY 11772-5543

Phone

(631) 320-5363

NPI assigned

Jul 16, 2026

Last updated

Jul 16, 2026By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Jennifer Fassino, LCSWNPI 1548542301

Title

Licensed Clinical Social Worker

Phone

(631) 445-4786

Specialties & licenses 1

Addresses

Practitioners 1

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.

• Jennifer Fassino

  • School Social Worker
  • Bellport, NY
  • NPI 1548542301
  Authorized official Same address or phone

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

{
    "created_epoch": "1784160000000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1784160000000",
    "number": "1538089081",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "335 N DUNTON AVE",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117725543",
            "telephone_number": "631-445-4786",
            "fax_number": "631-445-4786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "335 N DUNTON AVE",
            "city": "EAST PATCHOGUE",
            "state": "NY",
            "postal_code": "117725543",
            "telephone_number": "631-320-5363"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOARING FEATHERS LICENSED CLINICAL SOCIAL WORK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-07-16",
        "last_updated": "2026-07-16",
        "certification_date": "2026-07-16",
        "status": "A",
        "authorized_official_last_name": "FASSINO",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "LICENSED CLINICAL SOCIAL WORKER",
        "authorized_official_telephone_number": "631-445-4786",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Counselor, Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peter Joseph Sicardi Jr.
• Keera Siedlecki
• Sheila Sierra, RN
• Jason Simmons, MSOTR/L
• Maryann Skoblicki, RN
• Joo H Sohn, MD
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• Mental Health Counselor in East Patchogue, NY
• Providers in East Patchogue, NY by specialty
• Mental Health Counselor in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 16, 2026; 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.