SOUTHSHORE COUNSELING MEDIATION AND LICENSED CLINICAL SOCIAL WORK SERV
NPI 1366684078
Social Worker - Clinical in Brookhaven, NY

Q: What is Southshore Counseling Mediation And Licensed Clinical Social Work Serv's specialty?

The primary specialty registered for this NPI is Social Worker, specializing in Clinical, with taxonomy code 1041C0700X.

Active since March 26, 2009

36 EDGAR AVE, BROOKHAVEN, NY 11719(631) 286-8282(631) 803-6793 Get Directions Write a Review

NPPES record last updated: April 15, 2016. Verified against the NPPES registry weekly; last sync: October 25, 2026.

On this page

About Southshore Counseling Mediation And Licensed Clinical Social Work Serv NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

SOUTHSHORE COUNSELING MEDIATION AND LICENSED CLINICAL SOCIAL WORK SERV (NPI 1366684078) is a healthcare organization registered as a clinical in Brookhaven, New York and active in the NPI registry since March 2009. The organization lists Michelle Cavaleri, Executive Officer, as its authorized official.

NPPES Registry Identity

NPI1366684078

Entity TypeOrganization

Primary Taxonomy1041C0700X

Legal Business NameSOUTHSHORE COUNSELING MEDIATION AND LICENSED CLINICAL SOCIAL WORK SERV

Location Address36 EDGAR AVEBrookhaven, NY 11719-9655

Mailing Address36 Edgar AveBrookhaven, NY 11719-9655 · (631) 286-8282 · Fax (631) 803-6793

Phone(631) 286-8282

Fax(631) 803-6793

Organization SubpartNo

Authorized OfficialMichelle CavaleriExecutive Officer · (631) 286-8282

Enumeration DateMarch 26, 2009

Last NPPES UpdateApril 15, 2016

✔ NPI 1366684078 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtySocial Worker · ClinicalBehavioral Health & Social Service Providers

Taxonomy Code1041C0700X

License✔ Licensed in NY · 075548-1

Definition

A social worker who holds a master's or doctoral degree in social work from an accredited school of social work in addition to at least two years of post-master's supervised experience in a clinical setting. The social worker must be licensed, certified, or registered at the clinical level in the jurisdiction of practice. A clinical social worker provides direct services, including interventions focused on interpersonal interactions, intrapsychic dynamics, and life management issues. Clinical social work services are based on bio-psychosocial perspectives. Services consist of assessment, diagnosis, treatment (including psychotherapy and counseling), client-centered advocacy, consultation, evaluation, and prevention of mental illness, emotional, or behavioral disturbances.

36 EDGAR AVE, Brookhaven, NY 11719

Open in Google Maps ↗

Group Practice 1

Group TaxonomyThis provdier is a business group of one or more individual practitioners, all of who practice with the same area of specialization.193400000X SINGLE SPECIALTY GROUP

Medicare Participation & PECOS CMS

Medicare enrollment and the clinicians who bill Medicare through this organization, from CMS.

Medicare Enrollment Status

✔

Enrolled in Medicare (PECOS)

Southshore Counseling Mediation And Licensed Clinical Social Work Serv is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

Medicare enrollment records show 8 clinicians reassign Medicare billing to Southshore Counseling Mediation And Licensed Clinical Social Work Serv, which bills Medicare for the services they deliver. Of these, 5 practice at this address and 6 within 10 miles. They are listed nearest first.