Great South Bay Therapy LCSW PC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R03699 Issued in NY

Legal business name

GREAT SOUTH BAY THERAPY LCSW PC

Practice address

972 Montauk Hwy
Bayport, NY 11705-1612

Phone

(631) 472-2629

NPI assigned

Aug 28, 2018

Last updated

Jun 11, 2019By 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

Mrs. Jennifer Flanagan, LCSWNPI 1669696613

Title

President

Phone

(631) 472-2629

Specialties & licenses 1

Addresses

Locations

Practitioners 5

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.

• Jennifer Marie Flanagan, LCSW

  • Clinical Social Worker
  • Sayville, NY
  • NPI 1669696613
  NPD Authorized official
• Isabella Rose Albergo

  • Social Worker
  • Sayville, NY
  • NPI 1861356958
  NPD
• Kimberly Hession, LCSW

  • Clinical Social Worker
  • Sayville, NY
  • NPI 1134346059
  NPD
• Emily Perednia, LMSW

  • Social Worker
  • Sayville, NY
  • NPI 1598307779
  NPD (past)
• Rebecca Simari, LCSW

  • Social Worker
  • Sayville, NY
  • NPI 1154998961
  NPD (past)

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

{
    "created_epoch": "1535414400000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1560211200000",
    "number": "1710468517",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "972 MONTAUK HWY",
            "city": "BAYPORT",
            "state": "NY",
            "postal_code": "117051612",
            "telephone_number": "631-472-2629"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "972 MONTAUK HWY",
            "city": "BAYPORT",
            "state": "NY",
            "postal_code": "117051612",
            "telephone_number": "631-472-2629"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "GREAT SOUTH BAY THERAPY LCSW PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-08-28",
        "last_updated": "2019-06-11",
        "status": "A",
        "authorized_official_last_name": "FLANAGAN",
        "authorized_official_first_name": "JENNIFER",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "631-472-2629",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R03699",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Jennifer Gillanders, SLP
• Anna Gillis
• Karen Barbara Goercke, P.T.
• Arsh Gothra
• Catherine Gravano
• Kim Grennan, RN
• Ellen Jane Guerriero, D.D.S
• Tina Elizabeth Hager
• Patricia A Halcrow, LCSW-R
• Carin M Hamilton, RPH

• Clinical Social Worker in Bayport, NY
• Providers in Bayport, 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 Jun 11, 2019; 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.