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General NPI Number Information
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NPI Number | 1366793796
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Entity Type | Organization
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Legal Business Name | CHERYL BITTNER, LCSW P.C.
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Dates
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Enumeration Date | 09/25/2012
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Last Update Date | 09/25/2012
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Provider Practice Location Address
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Address Line | 88 TERRY RD SUITE 2
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City | SMITHTOWN
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State | NY
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Zip | 11787-3811
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Country | US
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Telephone | 631-786-2826
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Fax | 631-724-2028
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Provider Business Mailing Address
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Address Line | 88 TERRY RD SUITE 2
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City | SMITHTOWN
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State | NY
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Zip | 11787-3811
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Country | US
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Telephone | 631-786-2826
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Fax | 631-724-2028
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Authorized Official
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Title or Position | PRESIDENT/OWNER
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Name | CHERYL A BITTNER
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Credential | LCSW
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Telephone | 631-786-2826
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 079167
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License Number State | NY
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