Provider Demographics
NPI:1265016083
Name:CAHILL, MICHAELE ANNE (LMSW)
Entity Type:Individual
Prefix:
First Name:MICHAELE
Middle Name:ANNE
Last Name:CAHILL
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:29 S SAXON AVE
Mailing Address - Street 2:
Mailing Address - City:BAY SHORE
Mailing Address - State:NY
Mailing Address - Zip Code:11706-8940
Mailing Address - Country:US
Mailing Address - Phone:631-258-0487
Mailing Address - Fax:
Practice Address - Street 1:285 E MAIN ST STE LL5
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2980
Practice Address - Country:US
Practice Address - Phone:631-724-0600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-05-07
Last Update Date:2021-05-07
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY106223104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker