South Shore Collaborative Psychiatry NP PLLC

Primary specialty

Psychiatric/Mental Health Nurse PractitionerTaxonomy code 363LP0808X

Legal business name

SOUTH SHORE COLLABORATIVE PSYCHIATRY NP PLLC

Practice address

167 Broadway
Amityville, NY 11701-2782

Phone

(631) 317-9480

Fax

(231) 216-7467

NPI assigned

Apr 26, 2021

Last updated

Jul 25, 2025By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Samantha Roche, DNPNPI 1609277268

Title

Pmhnp-BC

Phone

(631) 317-9480

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 3

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.

• Samantha Roche, PMHNP-BC

  • Psychiatric/Mental Health Nurse Practitioner
  • Amityville, NY
  • NPI 1609277268
  Medicare reassignment NPD Authorized official
• Sharon Moira Friedman-Urevich, MSN,RN,FNP-C, PMHNP

  • Family Nurse Practitioner
  • East Northport, NY
  • NPI 1134182447
  Medicare reassignment
• Kenneth J Roche, LMHC

  • Mental Health Counselor
  • East Islip, NY
  • NPI 1578862728
  NPD (past)

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

{
    "created_epoch": "1619395200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1753401600000",
    "number": "1942882246",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "167 BROADWAY",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012782",
            "telephone_number": "631-317-9480",
            "fax_number": "231-216-7467"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "167 BROADWAY",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012782",
            "telephone_number": "631-317-9480",
            "fax_number": "231-216-7467"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "200 Carleton Ave",
            "address_purpose": "LOCATION",
            "city": "East Islip",
            "state": "NY",
            "postal_code": "117301222",
            "country_code": "US",
            "telephone_number": "631-317-9480",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SOUTH SHORE COLLABORATIVE PSYCHIATRY NP PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2021-04-26",
        "last_updated": "2025-07-25",
        "certification_date": "2025-07-25",
        "status": "A",
        "authorized_official_last_name": "ROCHE",
        "authorized_official_first_name": "SAMANTHA",
        "authorized_official_title_or_position": "PMHNP-BC",
        "authorized_official_telephone_number": "631-317-9480",
        "authorized_official_credential": "DNP"
    },
    "taxonomies": [
        {
            "code": "363LP0808X",
            "taxonomy_group": "",
            "desc": "Nurse Practitioner, Psychiatric/Mental Health",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• South Bay Counseling, LCSW PC
• South Bay Psychological, P.C.
• South Oaks Hospital
• South Shore Cardiovascular Medicine
• South Shore Cardiovascular Medicine P C
• South Shore Magnetic Resonance Imaging Associates PC (Brunswick Medical Services PC)
• South Shore Optometric Associates, PC
• South Shore Therapeutic Massage, P.C.
• Marie Spaccarotella, LMSW
• Spactrum Traders LLC

• Psychiatric/Mental Health Nurse Practitioner in Amityville, NY
• Providers in Amityville, NY by specialty
• Psychiatric/Mental Health Nurse Practitioner in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 25, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.