Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of October 4, 2026.

Fortitude Licensed Clinical Social Work PLLC

Organization Clinical Social Worker · NPI 1629982145

Fortitude Licensed Clinical Social Work PLLC provides Clinical Social Worker services in Bohemia, New York. Registered with an NPI since 2026.

In the registry since
2026
What do these letters mean?
PLLC — Professional limited liability company
A form of business registration, not a clinical qualification.

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Practice location Address checks out

80 Orville Dr Ste 100
Bohemia, NY 11716-2505
Phone: (419) 581-9810
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X

Record details

NPI number1629982145
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Joseph Conklin — Member · (419) 581-9810
NPI enumeratedOctober 1, 2026
Last updated in NPPESOctober 1, 2026
Certification dateSeptember 28, 2026
Mailing address80 Orville Dr Ste 100, Bohemia, NY 11716-2505

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