Individual
MS. BETTINA BOCCACCIO
Active
Sole proprietor
No
Provider details
NPI number
Gender
F
Credential
LCAT, LCSW
Contact information
Practice address
79 MIDDLEVILLE RD, NORTHPORT, NY 11768-2200
(631) 261-4400
Mailing address
79 MIDDLEVILLE RD, NORTHPORT, NY 11768-2200
(631) 261-4400
(631) 271-5497
Taxonomy
Speciality
Code
Description
License number
State
104100000X
Social Worker
091913
NY
1041C0700X
Clinical Social Worker
Primary
095172
NY
221700000X
Art Therapist
000024
NY
Other
Enumeration date
02/19/2008
Last updated
04/17/2023
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