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Organization
GREAT SOUTH BAY THERAPY LCSW PC
Active
Organization
GREAT SOUTH BAY THERAPY LCSW PC
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JENNIFER FLANAGAN LCSW (PRESIDENT)
(631) 472-2629
Entity
Organization
Contact information
Practice address
972 MONTAUK HWY, BAYPORT, NY 11705-1612
(631) 472-2629
Mailing address
972 MONTAUK HWY, BAYPORT, NY 11705-1612
(631) 472-2629
Taxonomy
Speciality
Code
Description
License number
State
1041C0700X
Clinical Social Worker
Primary
R03699
NY
Other
Enumeration date
08/28/2018
Last updated
06/11/2019
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