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GREAT SOUTH BAY THERAPY LCSW PC
NPI 1710468517
Social Worker - Clinical in Bayport, NY

Active since August 28, 2018
972 MONTAUK HWY, BAYPORT, NY 11705(631) 472-2629 Get Directions Write a Review

NPPES record last updated: June 11, 2019. Verified against the NPPES registry weekly; last sync: October 25, 2026.

Record update history: Jun 11, 2019, Aug 28, 2018 (2 updates tracked since 2018).

About Great South Bay Therapy Lcsw Pc NPPES

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

GREAT SOUTH BAY THERAPY LCSW PC (NPI 1710468517) is a healthcare organization registered as a clinical in Bayport, New York and active in the NPI registry since August 2018. The organization lists Jennifer Flanagan, President, as its authorized official.

NPPES Registry Identity

NPI1710468517
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameGREAT SOUTH BAY THERAPY LCSW PC
Location Address972 MONTAUK HWYBayport, NY 11705-1612
Mailing Address972 Montauk HwyBayport, NY 11705-1612 · (631) 472-2629
Phone(631) 472-2629
Organization SubpartNo
Authorized OfficialJennifer FlanaganPresident · (631) 472-2629
Enumeration DateAugust 28, 2018
Last NPPES UpdateJune 11, 20192 updates tracked since enumeration
✔ NPI 1710468517 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 · R03699
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.
972 MONTAUK HWY, Bayport, NY 11705
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Group Practice 1

Group TaxonomyThis provider is a business group of one or more individual practitioners, who practice with different areas of specialization.193200000X MULTI-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)

Great South Bay Therapy Lcsw Pc is registered in the CMS Provider Enrollment, Chain and Ownership System (PECOS).

Clinicians Billing Medicare Through This Organization

5

Medicare enrollment records show 5 clinicians reassign Medicare billing to Great South Bay Therapy Lcsw PC, which bills Medicare for the services they deliver. Of these, 1 practice at this address and 4 within 10 miles. They are listed nearest first.

Clinicians, nearest first (5)

Laura Pulitano
Mental Health Counselor
NPI 1942958426
972 MONTAUK HWY
Bayport, NY 11705
(631) 302-5181
✔ PECOSSame address
Kimberly Hession, LCSW
Clinical Social Worker
NPI 1134346059
296 N MAIN ST STE 1
Sayville, NY 11782
(631) 472-2629
✔ PECOS1.8 mi
Rebecca Simari, LCSW
Clinical Social Worker
NPI 1154998961
22 RAILROAD AVE
Sayville, NY 11782
(516) 902-4353
✔ PECOS2.2 mi
Emily Perednia, LMSW
Clinical Social Worker
NPI 1598307779
296 N MAIN ST
Sayville, NY 11782
(631) 472-2629
✔ PECOS2.6 mi
Emily Hordern
Marriage and Family Therapist
NPI 1154289569
26 HAMMOND RD
East Northport, NY 11731
(516) 361-5050
✔ PECOS16 mi

Source: CMS Revalidation Reassignment List, October 2026 release. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

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 Great South Bay Therapy Lcsw PC's NPI number?

The NPI number for Great South Bay Therapy Lcsw PC is 1710468517. It was assigned to this organization in the NPPES registry on August 28, 2018.

Where is Great South Bay Therapy Lcsw PC located?

Great South Bay Therapy Lcsw PC is located at 972 Montauk Hwy, Bayport, NY 11705. The listed phone number is (631) 472-2629.

What is Great South Bay Therapy Lcsw PC's specialty?

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

Is Great South Bay Therapy Lcsw PC enrolled in Medicare?

Yes. Great South Bay Therapy Lcsw PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through Great South Bay Therapy Lcsw PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 5 clinicians in 3 Medicare specialties reassign their Medicare billing to Great South Bay Therapy Lcsw PC. A reassignment is filed with Medicare on form CMS-855R, signed by both the clinician and the organization, and lets the organization bill Medicare and receive payment for the clinician's services. The largest specialties are Clinical Social Worker (3), Marriage and Family Therapist (1) and Mental Health Counselor (1). Of these, 1 practice at this address and 4 within 10 miles. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for Great South Bay Therapy Lcsw PC was last updated on June 11, 2019. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 7 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.