Provider Demographics
NPI:1437816014
Name:DRINKWINE, BRIAN (LMSW)
Entity Type:Individual
Prefix:
First Name:BRIAN
Middle Name:
Last Name:DRINKWINE
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3 QUAIL HOLLOW CT
Mailing Address - Street 2:
Mailing Address - City:SAINT JAMES
Mailing Address - State:NY
Mailing Address - Zip Code:11780-4241
Mailing Address - Country:US
Mailing Address - Phone:631-312-1020
Mailing Address - Fax:
Practice Address - Street 1:278 E MAIN ST
Practice Address - Street 2:
Practice Address - City:SMITHTOWN
Practice Address - State:NY
Practice Address - Zip Code:11787-2915
Practice Address - Country:US
Practice Address - Phone:631-361-6960
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-11-18
Last Update Date:2021-11-18
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY114833104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker