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SOUTH BAY COUNSELING, LCSW PC
NPI 1992112510
Social Worker - Clinical in Amityville, NY

Active since July 15, 2014
191 BROADWAY, AMITYVILLE, NY 11701(631) 264-0058(631) 264-0056 Get Directions Write a Review

NPPES record last updated: May 5, 2017. Verified against the NPPES registry weekly; last sync: October 25, 2026.

About South Bay Counseling, Lcsw Pc NPPES

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

SOUTH BAY COUNSELING, LCSW PC (NPI 1992112510) is a healthcare organization registered as a clinical in Amityville, New York and active in the NPI registry since July 2014. The organization lists Elissa Grunblatt, President/owner, as its authorized official.

NPPES Registry Identity

NPI1992112510
Entity TypeOrganization
Primary Taxonomy1041C0700X
Legal Business NameSOUTH BAY COUNSELING, LCSW PC
Location Address191 BROADWAYAmityville, NY 11701-2790
Mailing Address191 BroadwayAmityville, NY 11701-2790 · (631) 264-0058 · Fax (631) 264-0056
Phone(631) 264-0058
Fax(631) 264-0056
Organization SubpartNo
Authorized OfficialElissa GrunblattPresident/owner · (631) 264-0058
Enumeration DateJuly 15, 2014
Last NPPES UpdateMay 5, 2017
✔ NPI 1992112510 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 · 069889
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.
191 BROADWAY, Amityville, NY 11701
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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)

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

Clinicians Billing Medicare Through This Organization

2

Medicare enrollment records show 2 clinicians reassign Medicare billing to South Bay Counseling, Lcsw PC, which bills Medicare for the services they deliver. Of these, 1 practice at this address. They are listed nearest first.

Clinicians, nearest first (2)

Elissa Grunblatt, LCSW-R
Clinical Social Worker
NPI 1417961426
191 BROADWAY
Amityville, NY 11701
(631) 264-0058
✔ PECOS✔ Accepts MedicareSame address
Melissa Massimo, LCSW
Clinical Social Worker
NPI 1871091512
39 NEW HAMPSHIRE ST
Long Beach, NY 11561
(917) 331-8858
✔ PECOS✔ Accepts Medicare16 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 South Bay Counseling, Lcsw PC's NPI number?

The NPI number for South Bay Counseling, Lcsw PC is 1992112510. It was assigned to this organization in the NPPES registry on July 15, 2014.

Where is South Bay Counseling, Lcsw PC located?

South Bay Counseling, Lcsw PC is located at 191 Broadway, Amityville, NY 11701. The listed phone number is (631) 264-0058.

What is South Bay Counseling, Lcsw PC's specialty?

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

Is South Bay Counseling, Lcsw PC enrolled in Medicare?

Yes. South Bay Counseling, Lcsw PC is registered in the Medicare PECOS enrollment system.

How many clinicians bill Medicare through South Bay Counseling, Lcsw PC?

According to the CMS Revalidation Reassignment List (October 2026 release), 2 clinicians, all in Clinical Social Worker, reassign their Medicare billing to South Bay Counseling, 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. Of these, 1 practice at this address. Reassignment records can lag staffing changes; confirm a current affiliation with the organization.

When was this NPI record last updated?

The NPPES record for South Bay Counseling, Lcsw PC was last updated on May 5, 2017. NPI Profile syncs weekly with the NPPES registry data releases published by CMS. This NPI record was last updated 9 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.