Staley, Bobby L

Staley, Bobby L is an sole proprietor health care provider with primary practice located at 19605 Foothill Ave , Hollis NY 11423-1413. He recently has 2 registered licenses in different health care specialties including Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder), Behavioral Health & Social Service Providers / Clinical. Behavioral Health & Social Service Providers / Clinical is his primary health care specialty. Staley, Bobby L can be contacted via phone (917) 680-0082.

Contact Information

Primary practice address
19605 Foothill Ave Hollis NY 11423-1413
Phone: (917) 680-0082
Fax:
Website:
Map and Directions

Health care specialties

SpecialtyCodeLicense #State
Behavioral Health & Social Service Providers / Addiction (Substance Use Disorder) 101YA0400X 23692 New York
Behavioral Health & Social Service Providers / Clinical 1041C0700X 083565 New York

Profile Details

NPI number 1649512112
LBN Legal business name Staley, Bobby L
Credentials Licensed Clinical Social Worker (LCSW)
Entity Individual
Sole proprietor 1 Yes
Enumeration date Mar 22nd, 2013
Last updated Feb 7th, 2019 - about 5 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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