| Mrs Kim Stacey Spicciatie, LCSW | |
| 
					153 Simmons Dr, East Islip, NY 11730-3436  | |
| (631) 859-0738 | |
| Not Available | 
| Full Name | Mrs Kim Stacey Spicciatie | 
|---|---|
| Gender | Female | 
| Speciality | Social Worker - Clinical | 
| Location | 153 Simmons Dr, East Islip, New York | 
| Accepts Medicare Assignments | Medicare enrolled and may accept medicare through third-party reassignment. May prescribe medicare part D drugs. | 
| Identifier | Type | State | Issuer | 
|---|---|---|---|
| 1679857262 | NPI | - | NPPES | 
| Taxonomy | Type | License (State) | Status | 
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | 078707 (New York) | Primary | 
| Entity Name | North Shore-lij Medical Pc | 
|---|---|
| Entity Type | Part B Supplier - Clinic/group Practice | 
| Entity Identifiers | NPI Number: 1053688572 PECOS PAC ID: 3375701568 Enrollment ID: O20120220000262  | 
| Mailing Address | Practice Location Address | 
|---|---|
| Mrs Kim Stacey Spicciatie, LCSW 153 Simmons Dr, East Islip, NY 11730-3436 Ph: (631) 859-0738  | Mrs Kim Stacey Spicciatie, LCSW 153 Simmons Dr, East Islip, NY 11730-3436 Ph: (631) 859-0738  | 
Diane Kristina Witmer, LCSW Clinical Social Worker Medicare: Accepting Medicare Assignments Practice Location: 56 Marilynn St, East Islip, NY 11730 Phone: 631-338-3913  | |
Mrs. Jennifer Lynn Stinson, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 107 W Main St, East Islip, NY 11730 Phone: 631-666-1615  | |
Mrs. Suzanne Mary Bevis, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 107 W Main St, East Islip, NY 11730 Phone: 631-666-1615 Fax: 631-666-1709  | |
Mr. John Micheal Moore, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 15 Bayview Ave, East Islip, NY 11730 Phone: 631-581-2542  | |
Mrs. Helene Dellas-dibona, L.C.S.W.-R Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 216 Carleton Avenue, East Islip, NY 11730 Phone: 516-808-2488  | |
Mary Ozegovich, L.C.S.W. Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 6 Suffolk Ln, East Islip, NY 11730 Phone: 631-921-3558  | |
Ms. Susan Pilon, LCSW Clinical Social Worker Medicare: Not Enrolled in Medicare Practice Location: 55 Carleton Ave, East Islip, NY 11730 Phone: 631-835-4750  |