Southshore Counseling Mediation and Licensed Clinical Social Work Serv
NPI #1366684078 in Brookhaven, New York
Provider Information
- NPI Number
- 1366684078
- Entity Type
- Organization
- Organization Name
- Southshore Counseling Mediation and Licensed Clinical Social Work Serv
- Primary Specialty
- Social Worker - Clinical
- Enumeration Date
- Mar 26, 2009
- Last Updated
- Apr 15, 2016
Practice Location
- Address
- 36 EDGAR AVE
- City
- Brookhaven
- State
- New York
- ZIP Code
- 11719-9655
- Phone
- (631) 286-8282
Authorized Official
- Name
- MICHELLE CAVALERI, LCSW
- Title
- EXECUTIVE OFFICER
- Phone
- (631) 286-8282
Specialties & Taxonomy Codes
| Specialty |
|---|
| Social Worker - Clinical — Clinical |
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