| NPI | 1023349297 |
|---|---|
| Doing Business As | JEAN BACON |
| Entity Type | Organization |
| Authorized Contact | JEAN BACON Clinical Director 631-666-5067 |
| Organization Subpart ? | No |
| Primary Taxonomy | 1041C0700X Social Worker, Clinical (Licence: NY 04056) |
| Additional Taxonomies | 104100000X Social Worker (Licence: NY 076163) |
| 104100000X Social Worker (Licence: NY 079274) | |
| 104100000X Social Worker (Licence: NY 077806) | |
| 104100000X Social Worker (Licence: NY 070271) | |
| 104100000X Social Worker (Licence: NY 077805) | |
| 104100000X Social Worker (Licence: NY 074277) | |
| 104100000X Social Worker (Licence: NY 079551) | |
| 104100000X Social Worker (Licence: NY 075977) | |
| 104100000X Social Worker (Licence: NY 070508) | |
| 104100000X Social Worker (Licence: NY 073889) | |
| 104100000X Social Worker (Licence: NY 076780) | |
| 104100000X Social Worker (Licence: NY 074014) | |
| Enumeration Date | 2010-01-27 |
| Last Update Date | 2020-04-14 |