Organization Active NPI

South Shore Counseling, LCSW, PLLC

  • Local Education Agency (LEA)
  • Oakdale, NY
National Provider Identifier
1730073610
Registry record updated Jun 5, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Local Education Agency (LEA)Taxonomy code 251300000X
Legal business name
SOUTH SHORE COUNSELING, LCSW, PLLC
Practice address
755 Montauk Hwy
Oakdale, NY 11769-1801
Phone
(631) 602-0079
NPI assigned
Jun 5, 2025
Last updated
Jun 5, 2025By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jun 5, 2025

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

Authorized official

Name
Mrs. Lisa Dimitri, LCSW
Title
Clinical Director
Phone
(631) 602-0079

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Local Education Agency (LEA) 251300000X Primary

Addresses

Primary practice location

755 Montauk Hwy
Oakdale, NY 11769-1801

Mailing address

755 Montauk Hwy
Oakdale, NY 11769-1801
Phone (631) 602-0079

National Provider Directory

National Provider Directory

Locations

755 Montauk Hwy
Oakdale, NY 11769
Phone (631) 319-9283

NPI Registry JSON

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

{
    "created_epoch": "1749081600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1749081600000",
    "number": "1730073610",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "755 MONTAUK HWY",
            "city": "OAKDALE",
            "state": "NY",
            "postal_code": "117691801",
            "telephone_number": "631-602-0079"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "755 MONTAUK HWY",
            "city": "OAKDALE",
            "state": "NY",
            "postal_code": "117691801",
            "telephone_number": "631-602-0079"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SOUTH SHORE COUNSELING, LCSW, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-06-05",
        "last_updated": "2025-06-05",
        "certification_date": "2025-06-05",
        "status": "A",
        "authorized_official_last_name": "DIMITRI",
        "authorized_official_first_name": "LISA",
        "authorized_official_title_or_position": "CLINICAL DIRECTOR",
        "authorized_official_telephone_number": "631-602-0079",
        "authorized_official_name_prefix": "Mrs.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "251300000X",
            "taxonomy_group": "",
            "desc": "Local Education Agency (LEA)",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Oakdale, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2025; 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.