Organization Active NPI

Safe Shore Therapy LCSW, PLLC

  • Clinical Social Worker
  • Bay Shore, NY
National Provider Identifier
1922965748
Registry record updated Jan 5, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Legal business name
SAFE SHORE THERAPY LCSW, PLLC
Practice address
68 Johnson LN
Bay Shore, NY 11706-7813
Phone
(631) 319-0106
NPI assigned
Jan 5, 2026
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Jan 5, 2026

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

Authorized official

Name
Nicholas Edward Sieban, LCSWNPI 1750956728
Title
Member-Manager
Phone
(631) 319-0106

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: 193400000X SINGLE SPECIALTY GROUP 1041C0700X Primary

Addresses

Primary practice location

68 Johnson LN
Bay Shore, NY 11706-7813

Mailing address

244 E Main St Ste 119
East Islip, NY 11730-2712
Phone (631) 319-0106

National Provider Directory

National Provider Directory

Practitioners & affiliated clinicians

Practitioners 1

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": "1767571200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1767571200000",
    "number": "1922965748",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "244 E MAIN ST STE 119",
            "city": "EAST ISLIP",
            "state": "NY",
            "postal_code": "117302712",
            "telephone_number": "631-319-0106"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "68 JOHNSON LN",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117067813",
            "telephone_number": "631-319-0106"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "SAFE SHORE THERAPY LCSW, PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2026-01-05",
        "last_updated": "2026-01-05",
        "certification_date": "2026-01-05",
        "status": "A",
        "authorized_official_last_name": "SIEBAN",
        "authorized_official_first_name": "NICHOLAS",
        "authorized_official_middle_name": "EDWARD",
        "authorized_official_title_or_position": "MEMBER-MANAGER",
        "authorized_official_telephone_number": "631-319-0106",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bay Shore, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 5, 2026; 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.