Organization
BUTTERFLY CLINICAL INC.
Active
Other names
Jean Bacon
Organization subpart
No
Provider details
NPI number
Authorized official
JEAN BACON LCSW (DIRECTOR)
(631) 666-1951
Entity
Organization
Contact information
Practice address
250 W MAIN ST, BAY SHORE, NY 11706-8337
(631) 666-1951
Mailing address
250 W MAIN ST, BAY SHORE, NY 11706-8337
(631) 666-1951
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
070271
NY
104100000X
Social Worker
070508
NY
104100000X
Social Worker
073889
NY
104100000X
Social Worker
074014
NY
104100000X
Social Worker
075977
NY
104100000X
Social Worker
076163
NY
104100000X
Social Worker
076780
NY
104100000X
Social Worker
077805
NY
104100000X
Social Worker
079274
NY
104100000X
Social Worker
079551
NY
1041C0700X
Clinical Social Worker
Primary
045056
NY
Other
Enumeration date
05/14/2009
Last updated
01/25/2010
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