| Blossoms Of Change Counseling Lcsw Pllc | |
|
343 Oak Neck Rd West Islip NY 11795-3616 | |
| (631) 793-5250 | |
| Not Available |
| Full Name | Blossoms Of Change Counseling Lcsw Pllc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 343 Oak Neck Rd, West Islip, New York |
| Authorized Official Name and Position | Courtney A Jacobson (SOLE MEMBER) |
| Authorized Official Contact | 6317935250 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Blossoms Of Change Counseling Lcsw Pllc 343 Oak Neck Rd West Islip NY 11795-3616 Ph: (631) 793-5250 | Blossoms Of Change Counseling Lcsw Pllc 343 Oak Neck Rd West Islip NY 11795-3616 Ph: (631) 793-5250 |
| NPI Number | 1962271262 |
|---|---|
| Provider Enumeration Date | 12/27/2023 |
| Last Update Date | 12/27/2023 |
| Certification Date | 12/27/2023 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1962271262 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | (* (Not Available)) | Primary |
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