Provider Demographics
NPI:1063108082
Name:NORTH SHORE INSIGHT LCSW PLLC
Entity type:Organization
Organization Name:NORTH SHORE INSIGHT LCSW PLLC
Other - Org Name:<UNAVAIL>
Other - Org Type:
Authorized Official - Title/Position:PSYCHOTHERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:ROSEMARY
Authorized Official - Middle Name:
Authorized Official - Last Name:OCONNOR
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:631-524-1111
Mailing Address - Street 1:17 TRADEWINDS DR
Mailing Address - Street 2:
Mailing Address - City:BAYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11709-3013
Mailing Address - Country:US
Mailing Address - Phone:631-524-1111
Mailing Address - Fax:
Practice Address - Street 1:50 GLEN ST STE 311
Practice Address - Street 2:
Practice Address - City:GLEN COVE
Practice Address - State:NY
Practice Address - Zip Code:11542-2701
Practice Address - Country:US
Practice Address - Phone:929-324-7717
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-04-13
Last Update Date:2024-03-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty