CATHERINE PROVENZANO
NPI 1669875936
Social Worker - Clinical in Port Jefferson Station, NY

Active since October 01, 2014
1050 HALLOCK AVE, PORT JEFFERSON STATION, NY 11776(631) 487-5162 Get Directions Write a Review

NPPES record last updated: October 1, 2014. Verified against the NPPES registry weekly; last sync: August 23, 2026.

About Catherine Provenzano NPPES

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

CATHERINE PROVENZANO (NPI 1669875936) is a healthcare organization registered as a clinical in Port Jefferson Station, New York and active in the NPI registry since October 2014. The organization lists Catherine Provenzano, Clinical Social Worker, as its authorized official.

NPPES Registry Identity

NPI1669875936
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameCATHERINE PROVENZANO
Location Address1050 HALLOCK AVEPort Jefferson Station, NY 11776-1214
Mailing Address1050 Hallock AvePort Jefferson Station, NY 11776-1214 · (631) 487-5162
Organization SubpartNo
Authorized OfficialCatherine ProvenzanoClinical Social Worker · (631) 487-5162
Enumeration DateOctober 1, 2014
NPI 1669875936 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 · 081438
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.
1050 HALLOCK AVE, Port Jefferson Station, NY 11776

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

Other Providers at the Same Location NPPES 20

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

Social Worker (Clinical)
1050 HALLOCK AVE
PORT JEFFERSON STATION, NY 11776
Social Worker (Clinical)
1050 HALLOCK AVE
PORT JEFFERSON STATION, NY 11776
Social Worker (Clinical)
1050 HALLOCK AVE, SUITE 4
PORT JEFFERSON STATION, NY 11776
Social Worker (Clinical)
1050 HALLOCK AVE
PORT JEFFERSON STATION, NY 11776
Psychologist (Clinical)
1050 HALLOCK AVE
PORT JEFFERSON STATION, NY 11776
Counselor (Mental Health)
1050 HALLOCK AVE
PORT JEFFERSON STATION, NY 11776
Social Worker (Clinical)
1050 HALLOCK AVE
PORT JEFFERSON STATION, NY 11776
Psychologist (Clinical)
1050 HALLOCK AVE, SUITE 1
PORT JEFFERSON STATION, NY 11776

Frequently Asked Questions NPPES & CMS

Common questions about this NPI record, answered from the official NPPES registry and CMS datasets shown on this page.

What is Catherine Provenzano's NPI number?

The NPI number for Catherine Provenzano is 1669875936. It was assigned to this organization in the NPPES registry on October 1, 2014.

Where is Catherine Provenzano located?

Catherine Provenzano is located at 1050 Hallock Ave, Port Jefferson Station, NY 11776. The listed phone number is (631) 487-5162.

What is Catherine Provenzano's specialty?

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

When was this NPI record last updated?

The NPPES record for Catherine Provenzano was last updated on October 1, 2014. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 11 years ago. If this record has changed at CMS more recently, you can request an on-demand re-check against the live CMS registry, directly from this page.