Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.
NPIDirectory

Bridge Back to Life Center, Inc

Organization Clinical Social Worker · NPI 1265859078

Bridge Back to Life Center, Inc is a Clinical Social Worker in Bethpage, New York. Licensed in New York. Registered with an NPI since 2014.

Licensed in
NY
In the registry since
2014
Specialties on file
3
What do these letters mean?
Inc — Incorporated
A form of business registration, not a clinical qualification.

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Practice location Address checks out

4271 Hempstead Tpke
Bethpage, NY 11714-5708
Phone: (516) 520-6600
Fax: (212) 520-6750
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Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Clinical Social Worker (primary) Taxonomy 1041C0700X · Licence 160310678 (NY)
Addiction (Substance Use Disorder) Registered Nurse Taxonomy 163WA0400X · Licence 160310678 (NY)
Substance Use Disorder Rehabilitation Clinic/Center Taxonomy 261QR0405X

Record details

NPI number1265859078
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Gary Butchen — President · (516) 520-6600
NPI enumeratedMarch 19, 2014
Last updated in NPPESNovember 7, 2018
Mailing address4271 Hempstead Tpke, Bethpage, NY 11714-5708

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