New York Licensed Clinical Social Work, PC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

NEW YORK LICENSED CLINICAL SOCIAL WORK, PC

Practice address

5 Bertram St
Islip, NY 11751-1001

Phone

(866) 949-0108

NPI assigned

Nov 15, 2021

Organization subpart

No

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

Authorized official

Name

Kimberly Mann

Title

Credentialing Manager

Phone

(901) 422-7608

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.

• Karen Priest Hoffman

  • Clinical Social Worker
  • Ardsley, NY
  • NPI 1720739063
  NPD (past)

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

{
    "created_epoch": "1636934400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1640563200000",
    "number": "1669138699",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "50 S B B KING BLVD",
            "city": "MEMPHIS",
            "state": "TN",
            "postal_code": "381032626",
            "telephone_number": "901-422-7644"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5 BERTRAM ST",
            "city": "ISLIP",
            "state": "NY",
            "postal_code": "117511001",
            "telephone_number": "866-949-0108"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "NEW YORK LICENSED CLINICAL SOCIAL WORK, PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-11-15",
        "last_updated": "2021-12-27",
        "certification_date": "2021-12-27",
        "status": "A",
        "authorized_official_last_name": "MANN",
        "authorized_official_first_name": "KIMBERLY",
        "authorized_official_title_or_position": "CREDENTIALING MANAGER",
        "authorized_official_telephone_number": "901-422-7608"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Kathleen M Murphy
• Kaitlin Robin Murtaugh
• Lauran Nano
• Natalia Elson,DDS,PC
• Mary E Nelson, MS, LAC., LMT
• Next Generation Wellness Massage Therapy, PLLC
• Northland Hearing Centers, Inc. (Enhanced Hearing Systems)
• Catherine Julia Nunez
• Brenda Lynn O'Connell
• Oceana Device Corp

• Clinical Social Worker in Islip, NY
• Providers in Islip, 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 Dec 27, 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.