Fortitude Licensed Clinical Social Work PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

FORTITUDE LICENSED CLINICAL SOCIAL WORK PLLC

Practice address

80 Orville Dr Ste 100
Bohemia, NY 11716-2505

Phone

(419) 581-9810

NPI assigned

Oct 1, 2026

Last updated

Oct 1, 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

Mr. Joseph Conklin, LCSW, CASAC-ADVANCEDNPI 1194680520

Title

Member

Phone

(419) 581-9810

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.

• Joseph Conklin, LCSW, CASAC

  • Clinical Social Worker
  • Bohemia, NY
  • NPI 1194680520
  Authorized official Same address or phone

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

{
    "created_epoch": "1790812800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1790812800000",
    "number": "1629982145",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "80 ORVILLE DR STE 100",
            "city": "BOHEMIA",
            "state": "NY",
            "postal_code": "117162505",
            "telephone_number": "419-581-9810"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "80 ORVILLE DR STE 100",
            "city": "BOHEMIA",
            "state": "NY",
            "postal_code": "117162505",
            "telephone_number": "419-581-9810"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FORTITUDE LICENSED CLINICAL SOCIAL WORK PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-10-01",
        "last_updated": "2026-10-01",
        "certification_date": "2026-09-28",
        "status": "A",
        "authorized_official_last_name": "CONKLIN",
        "authorized_official_first_name": "JOSEPH",
        "authorized_official_title_or_position": "MEMBER",
        "authorized_official_telephone_number": "419-581-9810",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW, CASAC-ADVANCED"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kerry Ann Flavin, OTR/L
• Blair Alexandra Flynn
• Christopher T Foglia, D.C.
• Sara Folks, B.A.
• Grace Forestieri, M.S., CCC-SLP, ATP
• Barbara Jean Friedrich
• Full Stride Spine & Sport
• G F H Orthotic and Prosthetic Laboratories Inc
• Frances A. Gadue, M.S.
• Cristina Galian, LMSW

• Clinical Social Worker in Bohemia, NY
• Providers in Bohemia, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 1, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.