ASSOCIATION FOR MENTAL HEALTH AND WELLNESS INC (NPI# 1578516738) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1578516738 |
| Entity Type | Organization |
| Organization Name | ASSOCIATION FOR MENTAL HEALTH AND WELLNESS INC |
| Other Organization Name | CLUBHOUSE OF SUFFOLK, INC. |
| Practice Address |
939 Johnson Ave Ronkonkoma NY 11779-6066 |
| Practice Telephone | 6314717242 |
| Practice Fax Number | 6317380427 |
| Mailing Telephone | 6314717242 |
| Mailing Fax Number | 6317380427 |
| Enumeration Date | 2006-05-18 |
| Last Update Date | 2019-01-03 |
| Authorized Official Name | MS. PAULA J. FRIES (CHIEF OPERATING OFFICER) |
| Authorized Official Telephone | 6314717242 |
| Authorized Official Credential | LCAT |
| Is Organization Subpart | N |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| N | 251B00000X | Case Management | NY | Agencies | |
| N | 251S00000X | Community/Behavioral Health | 8587420A | NY | Agencies |
| N | 251S00000X | Community/Behavioral Health | 8587007A | NY | Agencies |
| Y | 251S00000X | Community/Behavioral Health | 8587006A | NY | Agencies |
| State | Issuer | Identifier | Type Code |
|---|---|---|---|
| NY | 02871841 | 05 | |
| NY | 02164405 | 05 | |
| NY | 02996261 | 05 | |
| NY | 01367064 | 05 | |
| NY | 02938489 | 05 |
| Other Name | Type Code |
|---|---|
| Clubhouse of Suffolk, Inc. | Former Legal Business Name - Organization |
| Street Address |
939 JOHNSON AVE |
| City | RONKONKOMA |
| State | NY |
| Zip Code | 11779-6066 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1154941797 | Brianna Oliveri | Social Worker | 939 Johnson Ave, Ronkonkoma, NY 11779-6066 | 2020-04-23 |
| 1861021230 | Christina Wieczorek | Social Worker | 939 Johnson Ave, Ronkonkoma, NY 11779-6066 | 2020-04-07 |
| 1336778703 | Linda S Rosasco | Social Worker | 939 Johnson Ave, Ronkonkoma, NY 11779-6066 | 2020-04-07 |
| 1154950525 | Keira Conrad | Social Worker | 939 Johnson Ave, Ronkonkoma, NY 11779-6066 | 2020-04-07 |
| 1366071730 | Stephen John Boose | Social Worker | 939 Johnson Ave, Ronkonkoma, NY 11779-6066 | 2020-04-07 |
| 1376179630 | Michael Baptiste | Social Worker | 939 Johnson Ave, Ronkonkoma, NY 11779-6066 | 2020-03-19 |
| 1356974299 | Dominique Nicole Zummo | Social Worker | 939 Johnson Ave, Ronkonkoma, NY 11779-6066 | 2020-02-19 |
| 1891338638 | Jillian Sarah Aiello | Social Worker | 939 Johnson Ave, Ronkonkoma, NY 11779-6066 | 2019-10-24 |
| 1578105904 | John Charles Mutziger Jr. | Counselor | 939 Johnson Ave, Ronkonkoma, NY 11779-6066 | 2019-10-17 |
| 1578114567 | Casey Ellen Lamarca | Social Worker | 939 Johnson Ave, Ronkonkoma, NY 11779 | 2019-09-23 |
| Find all providers in the same location | ||||
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1750929139 | Sebastian Godinez | Student in an Organized Health Care Education/Training Program | 11 First Street, Ronkonkoma, NY 11779 | 2019-12-16 |
| 1487149860 | John Deming | Student in an Organized Health Care Education/Training Program | 142 - 02 20th Avenue, Flushing, NY 11779 | 2018-06-27 |
| 1376060392 | Janine D'annunzio | Specialist | 316 Thirft Street, Ronkonkoma, NY 11779 | 2017-08-30 |
| 1932621935 | Vincent Joseph Lopreto | Counselor | 253 Lake Shore Road, Ronkonkoma, NY 11779 | 2017-07-11 |
| 1598295271 | Dalas Taddeo | Licensed Practical Nurse | 4490 Express Drive S, Ronkonkoma, NY 11779 | 2017-06-15 |
| 1790214112 | Pamela Ferrante | Social Worker | 131 Avenue D, Ronkonkoma, NY 11779 | 2017-06-08 |
| 1255868915 | Bari Home Care LLC | Health Maintenance Organization | 4417 Express Drive North, Ronkonkoma, NY 11779 | 2017-05-12 |
| 1013441328 | Caring Hands Home Care | Nursing Facility/Intermediate Care Facility | 65 Cheryl Drive, Ronkonkoma, NY 11779 | 2017-04-13 |
| 1831552025 | Jacqueline Galdamez | Social Worker | 979 Johnson Avenue, Ronkonkoma, NY 11779 | 2016-04-04 |
| 1891192530 | Alex Mitchell Pollack | Massage Therapist | 34 Richmond Blvd, #3a, Ronkonkoma, NY 11779 | 2014-11-24 |
| Find all providers in zip 11779 | ||||
| Taxonomy Code | 251S00000X |
| Grouping | Agencies |
| Classification | Community/Behavioral Health |
| A private or public agency usually under local government jurisdiction, responsible for assuring the delivery of community based mental health, mental retardation, substance abuse and/or behavioral health services to individuals with those disabilities. Services may range from companion care, respite, transportation, community integration, crisis intervention and stabilization, supported employment, day support, prevocational services, residential support, therapeutic and supportive consultation, environmental modifications, intensive in-home therapy and day treatment, in addition to traditional mental health and behavioral treatment. |
| Notes: Source: National Medicaid EDI HIPAA NPI Sub Work Group [1/1/2007: modified definition] |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1194974550 | Center for Addiction Recovery & Empowerment | Community/Behavioral Health | 2805 Veterans Highway, Suites 4 & 5, Ronkonkoma, NY 11779 | 2008-09-10 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1215538152 | Monette Counseling Services LLC | Community/Behavioral Health | 159 Margaret St Ste 225, Plattsburgh, NY 12901-1874 | 2020-11-06 |
| 1457959843 | Summit Alternatives Lmsw PC | Community/Behavioral Health | 215 North Cayuga Street, 2nd Floor Business Complex, Ithaca, NY 14850 | 2020-10-16 |
| 1407462948 | Shawn Muthersbaugh Lcsw Pllc | Community/Behavioral Health | 120 Defreest Dr Ste 175, Troy, NY 12180-7608 | 2020-09-21 |
| 1245845932 | Grow Healthcare Group Pa | Community/Behavioral Health | 2196 3rd Ave # 20071, New York, NY 10035-3501 | 2020-09-10 |
| 1104439728 | Andrea Brennan Licensed Mental Health Counseling, Pllc | Community/Behavioral Health | 245 Old Meadow Dr, Rochester, NY 14626-3548 | 2020-08-24 |
| 1831701630 | Debra L. Terry Lcsw, P.C. | Community/Behavioral Health | 4 Phyllis Dr Ste G, Patchogue, NY 11772-2900 | 2020-08-21 |
| 1750992079 | Trauma and Resiliency Resources, Inc. | Community/Behavioral Health | Winslow Therapeutic Center, 1433 Ny-17a, Warwick, NY 10990 | 2020-08-11 |
| 1598383796 | Chemung-schuyler Counties Chapter, Nysarc, Inc. | Community/Behavioral Health | 5297 Parkside Dr Ste 304, Canandaigua, NY 14424-7504 | 2020-07-14 |
| 1033737895 | Grow Care Inc | Community/Behavioral Health | 141 W 24th St Apt 5, New York, NY 10011-1958 | 2020-07-08 |
| 1043836943 | Cornerstone Behavioral Services, LLC. | Community/Behavioral Health | 3670 Orchard Rd, Wantagh, NY 11793-3131 | 2020-06-17 |
| Find all providers with the same taxonomy | ||||
| City | RONKONKOMA |
| Zip Code | 11779 |
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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.