# SOUTH SHORE COLLABORATIVE PSYCHIATRY NP PLLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1942882246
- **Authorized official:** SAMANTHA ROCHE DNP (PMHNP-BC)
- **Authorized official phone:** (631) 317-9480

## Contact information

- **Practice address:** 167 BROADWAY, AMITYVILLE, NY 11701-2782
- **Practice address phone:** (631) 317-9480
- **Practice address fax:** (231) 216-7467
- **Mailing address:** 167 BROADWAY, AMITYVILLE, NY 11701-2782
- **Mailing address phone:** (631) 317-9480
- **Mailing address fax:** (231) 216-7467

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 04/26/2021
- **Last updated:** 07/25/2025