Bacon, Donna Tyese

Bacon, Donna Tyese is an sole proprietor health care provider with primary practice located at 15 Harrison Ave #1A, Amityville NY 11701-2426. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Bacon, Donna Tyese can be contacted via phone (516) 884-4802.

Contact Information

Primary practice address
15 Harrison Ave #1A Amityville NY 11701-2426
Phone: (516) 884-4802
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Clinical 1041C0700X 070446 New York

Profile Details

NPI number 1821368077
LBN Legal business name Bacon, Donna Tyese
Credentials ED.D, LCSW, MSW, CT
Entity Individual
Sole proprietor 1 Yes
Enumeration date Jan 5th, 2012
Last updated Jan 5th, 2012 - about 13 years ago

1 A sole proprietor/sole proprietorship is an individual, and in that capacity, is qualified for a solitary NPI number. The sole proprietor have to apply for the NPI number using his or her own particular Social Security Number (SSN), instead of Employer Identification Number (EIN) regardless of whether he/she has an EIN.

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