Organization
BUTTERFLY CLINICAL
Active
Organization subpart
No
Provider details
NPI number
Authorized official
MRS. JEAN BACON PHD,LCSW-R (OWNER)
(631) 666-1951
Entity
Organization
Contact information
Practice address
250 MAIN ST, BAYSHORE, NY 11706
(631) 666-1951
Mailing address
250 MAIN ST, BAYSHORE, NY 11706
(631) 666-1951
Taxonomy
Speciality
Code
Description
License number
State
251S00000X
Community/Behavioral Health Agency
Primary
—
—
Other
Enumeration date
12/28/2006
Last updated
08/24/2009
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