SOUTH SHORE CHILD ASSOCIATION INCORPORATED (NPI# 1205972601) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1205972601 |
| Entity Type | Organization |
| Organization Name | SOUTH SHORE CHILD ASSOCIATION INCORPORATED |
| Other Organization Name | SOUTH SHORE CHILD GUIDANCE |
| Practice Address |
91 Guy Lombardo Ave 2nd Floor Freeport NY 11520-3731 |
| Practice Telephone | 5168683030 |
| Practice Fax Number | 5168683374 |
| Mailing Telephone | 5168683030 |
| Mailing Fax Number | 5168683374 |
| Enumeration Date | 2007-01-30 |
| Last Update Date | 2016-11-30 |
| Authorized Official Name | BARBARA ANN BARTOSZAK (ADMINISTRATOR) |
| Authorized Official Telephone | 5168683030 |
| Is Organization Subpart | Y |
| Parent Organization Name | SOUTH SHORE CHILD ASSOCIATION INCORPORATED |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251S00000X | Community/Behavioral Health | 080310993 | NY | Agencies |
| Y | 251B00000X | Case Management | 160310993 | NY | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | OASAS OPERATING CERTIFICA | 080310993 | 01 |
| NY | 00336943 | 05 | |
| NY | 03001127 | 05 |
| Other Name | Type Code |
|---|---|
| South Shore Child Guidance | Doing Business As Name - Organization |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023154507 | South Shore Child Association Incorporated | Case Management | 91 Guy Lombardo Ave, 2nd Floor, Freeport, NY 11520-3731 | 2007-01-30 |
| Street Address |
91 GUY LOMBARDO AVE 2ND FLOOR |
| City | FREEPORT |
| State | NY |
| Zip Code | 11520-3731 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1023154507 | South Shore Child Association Incorporated | Case Management | 91 Guy Lombardo Ave, 2nd Floor, Freeport, NY 11520-3731 | 2007-01-30 |
| 1962037341 | Rebecca Rose Dominguez | Social Worker | 91 Guy Lombardo Ave, Freeport, NY 11520-3731 | 2020-03-06 |
| 1881245843 | Sonia G Salas I | Social Worker | 91 Guy Lombardo Ave, Freeport, NY 11520-3731 | 2019-09-21 |
| 1770057606 | Freydi Aimet Santana | Social Worker | 91 Guy Lombardo Ave, Freeport, NY 11520-3731 | 2019-01-14 |
| 1639648918 | Cynthia Y Sanchez | Counselor | 91 Guy Lombardo Ave, Freeport, NY 11520-3731 | 2018-11-16 |
| 1447734512 | Taylor Elizabeth Schultz | Social Worker | 91 Guy Lombardo Ave, Freeport, NY 11520-3731 | 2018-09-24 |
| 1174019806 | Julie Quezada | Social Worker | 91 Guy Lombardo Ave, Freeport, NY 11520-3731 | 2018-07-05 |
| 1215445184 | Ximena Gutierrez | Social Worker | 91 Guy Lombardo Ave, Freeport, NY 11520-3731 | 2018-01-13 |
| 1679002265 | Guaroa Miguel Carias | Social Worker | 91 Guy Lombardo Ave, Freeport, NY 11520-3731 | 2017-06-07 |
| 1760917413 | Jaclyn Mirabile | Social Worker | 91 Guy Lombardo Ave, Freeport, NY 11520-3731 | 2017-05-01 |
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| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1881157154 | Barbara Chillemi | Registered Nurse | 56 Mackay Place, Freeport, NY 11520 | 2019-04-12 |
| 1588171631 | Lisa Frank | Nurse Practitioner | 150 Buffalo Ave, Freeport, NY 11520 | 2018-01-10 |
| 1447775838 | Julner Quettant Jr. | Physical Therapist | 63 St Marks Ave, Freeport, NY 11520 | 2017-08-07 |
| 1679003933 | Candice A R Greene | Speech-Language Pathologist | 12 Summers Place, Freeport, NY 11520 | 2017-06-19 |
| 1700310331 | Samantha Edwards | Psychologist | 6 Delisle Avenue, Freeport, NY 11520 | 2017-04-20 |
| 1275073769 | Dorothea Geiger | Behavior Technician | 90 Hillside Ave, Freeport, NY 11520 | 2017-03-02 |
| 1477092575 | Maryhaven Center of Hope,inc | Substance Abuse Rehabilitation Facility | 150 Buffalo Avenue, Freeport, NY 11520 | 2017-02-22 |
| 1861849135 | Daniel Lora | Acupuncturist | 140 Parsons Ave, Freeport, NY 11520 | 2016-05-17 |
| 1326413790 | Beatrice Jeanty | Registered Nurse | 619 South Long Beach Ave., Freeport, NY 11520 | 2015-12-10 |
| 1134505548 | Maria A. Meek | Nurse Practitioner | 334, West Merrick Rd., Freeport., NY 11520 | 2015-08-07 |
| Find all providers in zip 11520 | ||||
| Taxonomy Code | 251B00000X |
| Grouping | Agencies |
| Classification | Case Management |
| An organization that is responsible for providing case management services. The agency provides services which assist an individual in gaining access to needed medical, social, educational, and/or other services. Case management services may be used to locate, coordinate, and monitor necessary appropriate services. It may be used to encourage the use of cost-effective medical care by referrals to appropriate providers and to discourage over utilization of costly services. Case management may also serve to provide necessary coordination of non-medical services such as vocational rehabilitation, education, employment, when the services provided enable the individual to function at the highest level. |
| Notes: Source: CMS State Medicaid Manual Section 4442.3 [7/1/2006: definition modified] |
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| 1346408028 | Woodward Mental Health Center | Case Management | 201 W Merrick Rd, Freeport, NY 11520-3712 | 2008-05-29 |
| 1023154507 | South Shore Child Association Incorporated | Case Management | 91 Guy Lombardo Ave, 2nd Floor, Freeport, NY 11520-3731 | 2007-01-30 |
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| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.