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

Southshore Counseling Mediation and Licensed Clinical Social Work Serv

Organization Clinical Social Worker · NPI 1366684078

Southshore Counseling Mediation and Licensed Clinical Social Work Serv is a Clinical Social Worker in Brookhaven, New York. Licensed in New York. Registered with an NPI since 2009.

Licensed in
NY
In the registry since
2009

Practice location Address checks out

36 Edgar Ave
Brookhaven, NY 11719-9655
Phone: (631) 286-8282
Fax: (631) 803-6793
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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 · Licence 075548-1 (NY)

Record details

NPI number1366684078
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michelle Cavaleri — Executive Officer · (631) 286-8282
NPI enumeratedMarch 26, 2009
Last updated in NPPESApril 15, 2016
Mailing address36 Edgar Ave, Brookhaven, NY 11719-9655

Other providers in Brookhaven