Cecilia Brock, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

034485-1 Issued in NY

Practice address

353 Martha Ave
Esboces Brookhaven TSP
Bellport, NY 11713

Phone

(631) 286-6700

NPI assigned

Dec 2, 2010

Sex

Female

Sole proprietor

Yes

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.

• North Fork House Calls, LLC

  • General Practice Physician
  • Greenport, NY
  • NPI 1326404377
  NPD (past)

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

The complete NPPES record for this NPI in the NPI Registry API format, last updated by the provider on Dec 2, 2010.

{
    "created_epoch": "1291248000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1291248000000",
    "number": "1962704544",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "353 MARTHA AVE",
            "address_2": "ESBOCES BROOKHAVEN TSP",
            "city": "BELLPORT",
            "state": "NY",
            "postal_code": "11713",
            "telephone_number": "631-286-6700"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "353 MARTHA AVE",
            "address_2": "ESBOCES BROOKHAVEN TSP",
            "city": "BELLPORT",
            "state": "NY",
            "postal_code": "11713",
            "telephone_number": "631-286-6700"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BROCK",
        "first_name": "CECILIA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-12-02",
        "last_updated": "2010-12-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "034485-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Marissa Nicole Boscia-Wittekind, LMHC, CASAC
• Rachel Boykin, LPN
• Kathleen Brady, RN
• Tarabeth Marie Briscoe, L.P.N.
• Mary Brite
• Craig Brodmerkel
• Leslie Bromberg, LCSW-R
• Brookhaven Memorial Hospital Medical Center
• Brookhaven Memorial Hospital Medical Center
• Jill Buckley

• All providers in Bellport, NY
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 2, 2010; 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.