Suzanne L Velazquez, PH.D., L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

083415 Issued in NY

Practice address

83 E Main St
Bay Shore, NY 11706-8305

Phone

(631) 666-5067

NPI assigned

Apr 20, 2010

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

Credentials

Doctor of Philosophy

State licenses

Practice roles

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.

• Butterfly Clinical Inc.

  • Clinical Social Worker
  • Bay Shore, NY
  • NPI 1184858441
  NPD (past)
• Psychiatric Care Medical PLLC

  • Psychiatry Physician
  • Saint James, NY
  • NPI 1952946386
  NPD (past)

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

{
    "created_epoch": "1271721600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1992021604",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "208 E BROADWAY",
            "city": "PORT JEFFERSON",
            "state": "NY",
            "postal_code": "117771246",
            "telephone_number": "631-698-1736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "83 E MAIN ST",
            "city": "BAY SHORE",
            "state": "NY",
            "postal_code": "117068305",
            "telephone_number": "631-666-5067"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "208 E Broadway",
            "address_purpose": "LOCATION",
            "city": "Port Jefferson",
            "state": "NY",
            "postal_code": "117771246",
            "country_code": "US",
            "telephone_number": "631-431-3675",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "VELAZQUEZ",
        "first_name": "SUZANNE",
        "middle_name": "L",
        "name_prefix": "Dr.",
        "credential": "PH.D., L.C.S.W.",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2010-04-20",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "083415",
            "primary": true
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "077805",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Laura Vassallo
• David Vaughans, DO
• Kirkland C Vaughans
• Jessica Margaret Vecchio
• Gary Edwin Veith, M.D.
• Valeria Velez
• Brittney Veltri
• Nicole Veneziano, PT, DPT, OCS
• Rigoberto Ventura, PA-C
• Kendra Marie Verderosa

• Clinical Social Worker in Bay Shore, NY
• Providers in Bay Shore, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.