Provider Demographics
NPI:1497892244
Name:NEW BRIDGE EMPLOYEES ASSISTANCE SERVICES
Entity Type:Organization
Organization Name:NEW BRIDGE EMPLOYEES ASSISTANCE SERVICES
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:DIRECTOR LICENSED CLINICAL SOCIAL W
Authorized Official - Prefix:MR
Authorized Official - First Name:ROBERT
Authorized Official - Middle Name:T
Authorized Official - Last Name:HAZELTON
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:516-713-1952
Mailing Address - Street 1:3601 HEMPSTEAD TURNPIKE
Mailing Address - Street 2:STE LLM4
Mailing Address - City:LEVITTOWN
Mailing Address - State:NY
Mailing Address - Zip Code:11756
Mailing Address - Country:US
Mailing Address - Phone:516-713-1952
Mailing Address - Fax:516-799-9655
Practice Address - Street 1:3601 HEMPSTEAD TURNPIKE
Practice Address - Street 2:STE LLM4
Practice Address - City:LEVITTOWN
Practice Address - State:NY
Practice Address - Zip Code:11756
Practice Address - Country:US
Practice Address - Phone:516-713-1952
Practice Address - Fax:516-799-9655
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-31
Last Update Date:2020-08-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0345831041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty