Ellis, Susan O'Keeffe
Ellis, Susan O'Keeffe is an sole proprietor health care provider with primary practice located at 111 Smithtown Bypass Suite 108, Hauppauge NY 11788-2512. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Ellis, Susan O'Keeffe can be contacted via phone (516) 996-3892.Contact Information
Primary practice address
111 Smithtown Bypass Suite 108
Hauppauge NY 11788-2512
Phone: (516) 996-3892
Fax:
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | R040240-1 | New York |
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | 040240 | New York |
Profile Details
| NPI number | 1982693412 |
|---|---|
| LBN Legal business name | Ellis, Susan O'Keeffe |
| Credentials | LCSW-R |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Oct 18th, 2005 |
| Last updated | Jul 22nd, 2025 - about last year |
1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1982693412 | NPPES |
| New York | MEDICAID | 04228126 | |
| New York | Other | 10476641 |
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