Individual provider Active NPI

Christopher Halucha, LCSW

  • Clinical Social Worker
  • Hampton Bays, NY
National Provider Identifier
1912022013
Registry record updated May 14, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R0484651 Issued in NY
Practice address
17 School St
Hampton Bays, NY 11946-2614
Phone
(631) 276-5147
Fax
(631) 728-5369
NPI assigned
Mar 20, 2007
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 14, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R0484651 NY Primary

Addresses

Primary practice location

17 School St
Hampton Bays, NY 11946-2614

Mailing address

17 School St
Hampton Bays, NY 11946-2614
Phone (631) 276-5147

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20070605000587 NY Practitioner - Clinical Social Worker 2961500566 Practice locations: Hampton Bays, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1991
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

17 School St
Hampton Bays, NY 11946-2614
Phone (631) 276-5147

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
R0484651NYMDClinical Social Worker
048465NYMDPharmacist

Practice roles

OrganizationSpecialtyStatusNew patients
Heart & Soul Community Counseling Clinical PastSince May 8, 2019 Accepting new patients

Organizations & group practices 1

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1174348800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1747180800000",
    "number": "1912022013",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17 SCHOOL ST",
            "city": "HAMPTON BAYS",
            "state": "NY",
            "postal_code": "119462614",
            "telephone_number": "631-276-5147",
            "fax_number": "631-728-5369"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "17 SCHOOL ST",
            "city": "HAMPTON BAYS",
            "state": "NY",
            "postal_code": "119462614",
            "telephone_number": "631-276-5147",
            "fax_number": "631-728-5369"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "HALUCHA",
        "first_name": "CHRISTOPHER",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-03-20",
        "last_updated": "2025-05-14",
        "certification_date": "2025-05-14",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R0484651",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Hampton Bays, NY

Sources for this page

Verify at the official NPI Registry.