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

Mr. Bobby L Staley, LCSW

Individual provider Addiction (Substance Use Disorder) Counselor · NPI 1649512112

Mr. Bobby L Staley, LCSW is a Clinical Social Worker in Hollis, New York. Qualified in 2008, 18 years ago. Practices with Staley Psychiatric Nurse Practitioner PLLC, a 2-clinician group, accepts Medicare assignment and offers telehealth. Licensed in New York.

Years since qualifying
18
Licensed in
NY
In the registry since
2013
Specialties on file
2
What do these letters mean?
LCSW — Licensed Clinical Social Worker
A social worker licensed to diagnose and treat mental health conditions independently.

See every abbreviation used in this directory →

Practice location Address checks out

19605 Foothill Ave
Hollis, NY 11423-1413
Phone: (917) 680-0082
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 083565 (NY)
Addiction (Substance Use Disorder) Counselor Taxonomy 101YA0400X · Licence 23692 (NY)

Record details

NPI number1649512112
Entity typeIndividual (Type 1)
GenderMale
Credentials LCSW
Sole proprietorYes
NPI enumeratedMarch 22, 2013
Last updated in NPPESFebruary 7, 2019
Mailing address19825 Dunton Ave, 2nd Fl, Hollis, NY 11423-1409

Medicare enrollment

From the CMS Doctors & Clinicians file — this clinician is enrolled in Medicare.

Medicare specialtyCLINICAL SOCIAL WORKER
Medical schoolOTHER
Graduated 2008 (18 years in practice)
Group practice Staley Psychiatric Nurse Practitioner Pllc — 2 clinicians
Accepts Medicare assignment Yes — accepts the Medicare-approved amount
TelehealthOffers telehealth services
Practice locations2 on file with Medicare

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