Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

New York Licensed Clinical Social Work, PC

Organization Clinical Social Worker · NPI 1669138699

New York Licensed Clinical Social Work, PC provides Clinical Social Worker services in Islip, New York. Registered with an NPI since 2021.

In the registry since
2021
What do these letters mean?
PC — Professional corporation
A form of business registration, not a clinical qualification.

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Practice location Address checks out

5 Bertram St
Islip, NY 11751-1001
Phone: (866) 949-0108
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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 number1669138699
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Kimberly Mann — Credentialing Manager · (901) 422-7608
NPI enumeratedNovember 15, 2021
Last updated in NPPESDecember 27, 2021
Certification dateDecember 27, 2021
Mailing address50 S B B King Blvd, Memphis, TN 38103-2626

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