Jon Brennan, R-LCSW

Primary specialty

Mental Health CounselorTaxonomy code 101YM0800X

License

R044718-1 Issued in NY

Practice address

408 Montauk Hwy
Center Moriches, NY 11934-3518

Phone

(631) 874-0185

Fax

(631) 909-8940

NPI assigned

Jun 4, 2018

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

State University of New York at Stony Brook, School of Medicine, 1991

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Telehealth

Offers telehealth services

Group practices

Community Counseling and LCSW ServicesGroup PAC ID 3577605617, 17 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Community Counseling & LCSW Services PC

  • Clinical Social Worker
  • Center Moriches, NY
  • NPI 1770819690
  Medicare reassignment Care Compare group NPD
• Visiting Counselors of New York, LCSW, PLLC

  • Clinical Social Worker
  • Melville, NY
  • NPI 1669906889
  Medicare reassignment NPD
• Qureshi Medical Services PLLC

  • Psychiatry Physician
  • Center Moriches, NY
  • NPI 1316763162
  NPD (past)

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

{
    "created_epoch": "1528070400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1578528000000",
    "number": "1659863868",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "76 WOODLAND RD",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117641944",
            "telephone_number": "631-509-5551"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "408 MONTAUK HWY",
            "city": "CENTER MORICHES",
            "state": "NY",
            "postal_code": "119343518",
            "telephone_number": "631-874-0185",
            "fax_number": "631-909-8940"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "900 Walt Whitman Rd",
            "address_purpose": "LOCATION",
            "city": "Melville",
            "state": "NY",
            "postal_code": "117472293",
            "country_code": "US",
            "telephone_number": "516-698-5511",
            "fax_number": "516-418-5377",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "BRENNAN",
        "first_name": "JON",
        "credential": "R-LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2018-06-04",
        "last_updated": "2020-01-09",
        "certification_date": "2020-01-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TM1800X",
            "taxonomy_group": "",
            "desc": "Psychologist, Intellectual & Developmental Disabilities",
            "state": "NY",
            "license": "R044718-1",
            "primary": false
        },
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "R044718-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Pramod Bhanti, PT
• Jaclyn Marie Bonventre
• Amanda Loree Bowcock, LMHC
• Patricia M Brandt
• Breakthrough Living Mental Health Counseling PLLC
• Emily Ann Brophy
• Alek Brown
• Gina M. Bruno, LPN
• Elisabeth Burrelli, LMHC
• Tanya Byrnes, LMSW

• Mental Health Counselor in Center Moriches, NY
• Providers in Center Moriches, 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 Jan 9, 2020; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.