Bourbin, Susan Joan
Bourbin, Susan Joan is an sole proprietor health care provider with primary practice located at 15 Horseblock Place , Farmingville NY 11738. She recently has only one registered license in Behavioral Health & Social Service Providers / Clinical, which is considered as her primary health care specialty. Bourbin, Susan Joan can be contacted via phone (631) 854-2552.Contact Information
Primary practice address
15 Horseblock Place
Farmingville NY 11738
Phone: (631) 854-2552
Fax: (631) 854-2550
Website:
Health care specialties
| Specialty | Code | License # | State |
|---|---|---|---|
| Behavioral Health & Social Service Providers / Clinical | 1041C0700X | RO49752-1 | New York |
Profile Details
| NPI number | 1700958212 |
|---|---|
| LBN Legal business name | Bourbin, Susan Joan |
| Credentials | LACSW-R |
| Entity | Individual |
| Sole proprietor 1 | Yes |
| Enumeration date | Nov 14th, 2006 |
| Last updated | Jul 8th, 2007 - about 17 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.
Identifiers
| State | Type | Number | Issuer |
|---|---|---|---|
| All States | NPI | 1700958212 | NPPES |
| New York | Other | RO49752-1 | SW LICENSE # |
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