# TOWN OF ISLIP

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- **Entity:** Organization
- **Status:** Active
- **Other names:** Access
- **Organization subpart:** No

## Provider details

- **NPI number:** 1548369143
- **Authorized official:** DELORES BOCKLET (DIRECTOR)
- **Authorized official phone:** (631) 224-5330

## Contact information

- **Practice address:** 401 MAIN ST, ISLIP, NY 11751-3560
- **Practice address phone:** (631) 224-5330
- **Practice address fax:** (631) 224-1206
- **Mailing address:** 401 MAIN ST, ROOM 132, ISLIP, NY 11751-3560
- **Mailing address phone:** (631) 224-5330
- **Mailing address fax:** (631) 224-1206

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 101YA0400X | Addiction (Substance Use Disorder) Counselor | 080611082 | NY | Yes |

## Other

- **Enumeration date:** 09/21/2006
- **Last updated:** 06/12/2008