Provider Demographics
NPI:1992986814
Name:TUSA, JOHN JAMES (LICENSED CLINICAL SW)
Entity type:Individual
Prefix:MR
First Name:JOHN
Middle Name:JAMES
Last Name:TUSA
Suffix:
Gender:
Credentials:LICENSED CLINICAL SW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4 LONG SPRINGS RD
Mailing Address - Street 2:
Mailing Address - City:SOUTHAMPTON
Mailing Address - State:NY
Mailing Address - Zip Code:11968-2503
Mailing Address - Country:US
Mailing Address - Phone:631-283-2729
Mailing Address - Fax:631-287-6556
Practice Address - Street 1:4 LONG SPRINGS RD
Practice Address - Street 2:
Practice Address - City:SOUTHAMPTON
Practice Address - State:NY
Practice Address - Zip Code:11968-2503
Practice Address - Country:US
Practice Address - Phone:631-283-2729
Practice Address - Fax:631-287-6556
Is Sole Proprietor?:No
Enumeration Date:2007-11-20
Last Update Date:2025-04-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR050085104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
Provider Identifiers
StateIdentifier IDID TypeIssuer
82586OtherOXFORD
148743OtherVYTRA