NPIMap

Organization Active NPI

Family Integrated Consulting and Resources, Inc

  • Clinical Social Worker
  • Riverhead, NY
National Provider Identifier
1881164085
Registry record updated Nov 29, 2018
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
FAMILY INTEGRATED CONSULTING AND RESOURCES, INC
Practice address
1394 Roanoke Ave Ste a
Riverhead, NY 11901-2100
Phone
(631) 838-7183
NPI assigned
Nov 29, 2018
Last updated
Nov 29, 2018By the provider in NPPES
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Nov 29, 2018

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

Authorized official

Name
Mr. Joshua Hendrickson David Hendrickson, LCSW
Title
Owner
Phone
(631) 838-7183

Specialties & licenses 3

Specialty (taxonomy)CodeLicenseStatePrimary
Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 104100000X
Clinical Social WorkerGroup: 193200000X MULTI-SPECIALTY GROUP 1041C0700X Primary
Massage TherapistGroup: 193200000X MULTI-SPECIALTY GROUP 225700000X

Addresses

Primary practice location

1394 Roanoke Ave Ste a
Riverhead, NY 11901-2100

Mailing address

1394 Roanoke Ave Ste a
Riverhead, NY 11901-2100
Phone (631) 838-7183

Other identifiers 1

IdentifierTypeStateIssuer
365022680OtherNYAETNA, BEACON HEALTH OPTIONS, UNITED HEALTH CARE, SEU 1199, GEHA, ALLIED HEALTH

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 2

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.

NPI Registry JSON

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

{
    "created_epoch": "1543449600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1543449600000",
    "number": "1881164085",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1394 ROANOKE AVE STE A",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012100",
            "telephone_number": "631-838-7183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1394 ROANOKE AVE STE A",
            "city": "RIVERHEAD",
            "state": "NY",
            "postal_code": "119012100",
            "telephone_number": "631-838-7183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "FAMILY INTEGRATED CONSULTING AND RESOURCES, INC",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-11-29",
        "last_updated": "2018-11-29",
        "status": "A",
        "authorized_official_last_name": "HENDRICKSON",
        "authorized_official_first_name": "JOSHUA HENDRICKSON",
        "authorized_official_middle_name": "DAVID",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "631-838-7183",
        "authorized_official_name_prefix": "Mr.",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        },
        {
            "code": "225700000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Massage Therapist",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA, BEACON HEALTH OPTIONS, UNITED HEALTH CARE, SEU 1199, GEHA, ALLIED HEALTH",
            "identifier": "365022680",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Riverhead, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 29, 2018; 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.