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

Staten Island Psychotherapy LCSW PLLC

Organization Clinical Social Worker · NPI 1124844808

Staten Island Psychotherapy LCSW PLLC is a Clinical Social Worker in Staten Island, New York. Registered with an NPI since 2024.

In the registry since
2024
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

3974 Amboy Rd Ste 207
Staten Island, NY 10308-2414
Phone: (718) 344-7272
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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 number1124844808
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Michelle Tully — Member · (718) 344-7272
NPI enumeratedNovember 27, 2024
Last updated in NPPESNovember 27, 2024
Certification dateNovember 27, 2024
Mailing address3974 Amboy Rd Ste 207, Staten Island, NY 10308-2414

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