The Young Men'S Christian Association of Long Island Incorporated

Primary specialty

Substance Use Disorder Rehabilitation Clinic/CenterTaxonomy code 261QR0405X

License

70611543 Issued in NY

Legal business name

THE YOUNG MEN'S CHRISTIAN ASSOCIATION OF LONG ISLAND INCORPORATED

Practice address

1150 Portion Rd
Suite 6
Holtsville, NY 11742-1074

Phone

(631) 580-7777

Fax

(631) 580-7773

NPI assigned

Nov 22, 2006

Organization subpart

No

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

Authorized official

Name

Mr. Mark Katzenberger

Title

Cfo

Phone

(516) 674-8290

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 1

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

• Barbara McKenna Folks, LCSW-R

  • Clinical Social Worker
  • Medford, NY
  • NPI 1518311869
  Medicare reassignment NPD

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

{
    "created_epoch": "1164153600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1491177600000",
    "number": "1952476129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1150 PORTION RD",
            "address_2": "SUITE 6",
            "city": "HOLTSVILLE",
            "state": "NY",
            "postal_code": "117421074",
            "telephone_number": "631-580-7777",
            "fax_number": "631-580-7773"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1150 PORTION RD",
            "address_2": "SUITE 6",
            "city": "HOLTSVILLE",
            "state": "NY",
            "postal_code": "117421074",
            "telephone_number": "631-580-7777",
            "fax_number": "631-580-7773"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "THE YOUNG MEN'S CHRISTIAN ASSOCIATION OF LONG ISLAND INCORPORATED",
        "organizational_subpart": "NO",
        "enumeration_date": "2006-11-22",
        "last_updated": "2017-04-03",
        "status": "A",
        "authorized_official_last_name": "KATZENBERGER",
        "authorized_official_first_name": "MARK",
        "authorized_official_title_or_position": "CFO",
        "authorized_official_telephone_number": "516-674-8290",
        "authorized_official_name_prefix": "Mr."
    },
    "taxonomies": [
        {
            "code": "174H00000X",
            "taxonomy_group": "193200000X MULTI-SPECIALTY GROUP",
            "desc": "Health Educator",
            "state": null,
            "license": null,
            "primary": false
        },
        {
            "code": "261QR0405X",
            "taxonomy_group": "",
            "desc": "Clinic/Center, Rehabilitation, Substance Use Disorder",
            "state": "NY",
            "license": "70611543",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Catherine J Sullivan, NP
• Sunshine Pediatric Occupational Therapy PC
• Jennifer Concetta Tabachnick, RD
• Yanick Telfort, R.N.
• Alan Carl Tener, PH.D.
• Lori Thompson-Maranda, LMSW
• Charlee Timmerman
• Deirdre Mary Tobin
• Luz Idalia Torres, LCSW
• Kathleen Reilly Valdakis

• Substance Use Disorder Rehabilitation Clinic/Center in Holtsville, NY
• Providers in Holtsville, NY by specialty
• Substance Use Disorder Rehabilitation Clinic/Center in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2017; 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.