| Great South Bay Therapy Lcsw Pc | |
|
972 Montauk Hwy Bayport NY 11705-1612 | |
| (631) 472-2629 | |
| Not Available |
| Full Name | Great South Bay Therapy Lcsw Pc |
|---|---|
| Speciality | Social Worker - Clinical |
| Location | 972 Montauk Hwy, Bayport, New York |
| Authorized Official Name and Position | Jennifer Flanagan (PRESIDENT) |
| Authorized Official Contact | 6314722629 |
| Accepts Medicare Insurance | This clinic does not participate in Medicare Program. |
| Mailing Address | Practice Location Address |
|---|---|
| Great South Bay Therapy Lcsw Pc 972 Montauk Hwy Bayport NY 11705-1612 Ph: (631) 472-2629 | Great South Bay Therapy Lcsw Pc 972 Montauk Hwy Bayport NY 11705-1612 Ph: (631) 472-2629 |
| NPI Number | 1710468517 |
|---|---|
| Provider Enumeration Date | 08/28/2018 |
| Last Update Date | 06/11/2019 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1710468517 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 1041C0700X | Social Worker - Clinical | R03699 (New York) | Primary |
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