Individual provider Active NPI

Brian R Coyle, LMSW

  • Counselor
  • Bay Shore, NY
National Provider Identifier
1669953758
Registry record updated Aug 27, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
CounselorTaxonomy code 101Y00000X
License
101523-1 Issued in NY
Practice address
83 E Main St
Bay Shore, NY 11706-8305
Phone
(631) 666-1951
NPI assigned
Aug 27, 2018
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 27, 2018

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Counselor 101Y00000X 101523-1 NY Primary

Addresses

Primary practice location

83 E Main St
Bay Shore, NY 11706-8305

Mailing address

31 Willow Ave
Islip, NY 11751-3915
Phone (631) 859-3436

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
101523-1NYMDCounselor

Practice roles

OrganizationSpecialtyStatusNew patients
Butterfly LCSW PC CurrentSince Jan 5, 2022 Accepting new patients
Butterfly Clinical Inc. Past Accepting new patients
Psychiatric Care Medical PLLC Past Accepting new patients

Locations

83 E Main St
Bay Shore, NY 11706
Phone (631) 666-1951

1735 N Ocean Ave
Ste D
Medford, NY 11763
Phone (631) 666-5067

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1535328000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1535328000000",
    "number": "1669953758",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "31 WILLOW AVE",
            "city": "ISLIP",
            "state": "NY",
            "postal_code": "117513915",
            "telephone_number": "631-859-3436"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068305",
            "telephone_number": "631-666-1951"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "COYLE",
        "first_name": "BRIAN",
        "middle_name": "R",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-08-27",
        "last_updated": "2018-08-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NY",
            "license": "101523-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

Verify at the official NPI Registry.