| North Shore Youth Council Inc | |
|
525 Route 25a Rocky Point NY 11778-8885 | |
| (631) 744-0207 | |
| Not Available |
| Full Name | North Shore Youth Council Inc |
|---|---|
| Speciality | Counselor |
| Location | 525 Route 25a, Rocky Point, New York |
| Authorized Official Name and Position | Barbara J Brennan (THERAPIST) |
| Authorized Official Contact | 6317440207 |
| Accepts Medicare Insurance | Yes. This clinic participates in medicare program and accept medicare insurance. |
| Mailing Address | Practice Location Address |
|---|---|
| North Shore Youth Council Inc Po Box 1286 Rocky Point NY 11778-1286 Ph: (631) 744-0207 | North Shore Youth Council Inc 525 Route 25a Rocky Point NY 11778-8885 Ph: (631) 744-0207 |
| NPI Number | 1255924775 |
|---|---|
| Provider Enumeration Date | 02/16/2021 |
| Last Update Date | 09/11/2023 |
| Certification Date | 09/11/2023 |
| Medicare PECOS PAC ID | 4385098359 |
|---|---|
| Medicare Enrollment ID | O20230925001898 |
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 1255924775 | NPI | - | NPPES |
| Taxonomy | Type | License (State) | Status |
|---|---|---|---|
| 101YM0800X | Counselor - Mental Health | (* (Not Available)) | Primary |
| Provider Name | Barbara J Brennan |
|---|---|
| Provider Type | Practitioner - Clinical Social Worker |
| Provider Identifiers | NPI Number: 1710410410 PECOS PAC ID: 5890059992 Enrollment ID: I20180425001514 |
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