Phoenix Houseof Ny, Inc.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

069641 Issued in NY

Legal business name

PHOENIX HOUSEOF NY, INC.

Practice address

283 Springs Fireplace Rd
East Hampton, NY 11937-4823

Phone

(631) 329-0373

Fax

(631) 907-9345

NPI assigned

Dec 8, 2008

Organization subpart

No

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

Authorized official

Name

Ms. Michele Rothar, LCSW

Title

Social Worker

Phone

(631) 329-0373

Specialties & licenses 1

Addresses

Locations

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• John Joseph McGovern, LCSW, PH.D.

  • Clinical Social Worker
  • East Hampton, NY
  • NPI 1316225832
  NPD (past)

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

{
    "created_epoch": "1228694400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1228694400000",
    "number": "1710122536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "283 SPRINGS FIREPLACE RD",
            "city": "EAST HAMPTON",
            "state": "NY",
            "postal_code": "119374823",
            "telephone_number": "631-329-0373",
            "fax_number": "631-907-9345"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "283 SPRINGS FIREPLACE RD",
            "city": "EAST HAMPTON",
            "state": "NY",
            "postal_code": "119374823",
            "telephone_number": "631-329-0373",
            "fax_number": "631-907-9345"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "PHOENIX HOUSEOF NY, INC.",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-12-08",
        "last_updated": "2008-12-08",
        "status": "A",
        "authorized_official_last_name": "ROTHAR",
        "authorized_official_first_name": "MICHELE",
        "authorized_official_title_or_position": "SOCIAL WORKER",
        "authorized_official_telephone_number": "631-329-0373",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "069641",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Peterson Medical Supply Company
• Anthony Petrello, PHARMD
• Eric Pettigrew
• Patricia Philipbar, MA, CCC-LSP
• Amy Phillips
• Taylor Rose Poltorak
• Louis S Profera, DDS
• Alanna Anne Quinn, LMSW
• Ralph M Gibson M D P C
• Terri A Rauch, D.C.

• Clinical Social Worker in East Hampton, NY
• Providers in East Hampton, 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 8, 2008; 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.