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Organization

SAFE SHORE THERAPY LCSW, PLLC

Active
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Organization

SAFE SHORE THERAPY LCSW, PLLC

Active
Organization subpart
No

Provider details

NPI number
Authorized official
NICHOLAS EDWARD SIEBAN LCSW (MEMBER-MANAGER)
(631) 319-0106
Entity
Organization

Contact information

Practice address
68 JOHNSON LN, BAY SHORE, NY 11706-7813
(631) 319-0106
Mailing address
244 E MAIN ST STE 119, EAST ISLIP, NY 11730-2712
(631) 319-0106

Taxonomy

Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
—
—

Other

Enumeration date
01/05/2026
Last updated
01/05/2026
About Stedi
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  • EDI platform