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 is a Clinical Social Worker 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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