NPIMap

Organization Active NPI

Setauket Licensed Clinical Social Work Consultation Services PLLC

  • Clinical Social Worker
  • East Setauket, NY
National Provider Identifier
1801073184
Registry record updated May 13, 2011
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R0276581 Issued in NY
Legal business name
SETAUKET LICENSED CLINICAL SOCIAL WORK CONSULTATION SERVICES PLLC
Doing business as
SETAUKET CONSULTATION CENTER
Practice address
100 S Jersey Ave
Unit 42
East Setauket, NY 11733-2034
Phone
(631) 689-1728
NPI assigned
Jan 29, 2008
Organization subpart
No

NPPES NPI Registry

Updated by the provider on May 13, 2011

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

Authorized official

Name
Mr. Paul Botticelli, LCSW-RNPI 1457499808
Title
Director
Phone
(631) 689-1728

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X R0276581 NY Primary

Addresses

Primary practice location

100 S Jersey Ave
Unit 42
East Setauket, NY 11733-2034

Mailing address

100 S Jersey Ave
Unit 42
East Setauket, NY 11733-2034
Phone (631) 689-1728

Other identifiers 2

IdentifierTypeStateIssuer
501512OtherNYVALUE OPTIONS
7336094OtherNYGHI

Other names 1

  • SETAUKET CONSULTATION CENTER Doing business as

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 4

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

NPI Registry JSON

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

{
    "created_epoch": "1201564800000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1305244800000",
    "number": "1801073184",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "100 S JERSEY AVE",
            "address_2": "UNIT 42",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117332034",
            "telephone_number": "631-689-1728"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "100 S JERSEY AVE",
            "address_2": "UNIT 42",
            "city": "EAST SETAUKET",
            "state": "NY",
            "postal_code": "117332034",
            "telephone_number": "631-689-1728"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SETAUKET LICENSED CLINICAL SOCIAL WORK CONSULTATION SERVICES PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2008-01-29",
        "last_updated": "2011-05-13",
        "status": "A",
        "authorized_official_last_name": "BOTTICELLI",
        "authorized_official_first_name": "PAUL",
        "authorized_official_title_or_position": "DIRECTOR",
        "authorized_official_telephone_number": "631-689-1728",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW-R"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0276581",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUE OPTIONS",
            "identifier": "501512",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "7336094",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": [
        {
            "organization_name": "SETAUKET CONSULTATION CENTER",
            "code": "3",
            "type": "Doing Business As"
        }
    ]
}

Other providers in East Setauket, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 13, 2011; 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.