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Data from the NPPES registry. May not reflect recent changes — verify at nppes.cms.hhs.gov.

SOUTHSHORE COUNSELING MEDIATION AND LICENSED CLINICAL SOCIAL WORK SERV

Active Organization

Clinical Social Worker · BROOKHAVEN, NY

Registration Details

NPI Number
1366684078
Provider Type
Organization
NPI Issued
Mar 26, 2009 (17.123032646487 yrs)
Last Updated
Apr 15, 2016
License
075548-1 (NY)

Practice Information

Address
36 EDGAR AVE
BROOKHAVEN, NY, 117199655
Browse NY providers · Browse ZIP 11719
Phone
6312868282
Fax
6318036793
Primary Specialty
Clinical Social Worker
1041C0700X
Data sourced from the NPPES National Provider Identifier registry. Healthcare organizations registered in NPPES are assigned an NPI number for use in insurance billing and claims. This information is for informational purposes only. For official verification, use the NPPES NPI Registry.