Provider Demographics
NPI:1477869048
Name:MORALES, BRUSELINDA (CASAC-T)
Entity type:Individual
Prefix:MS
First Name:BRUSELINDA
Middle Name:
Last Name:MORALES
Suffix:
Gender:F
Credentials:CASAC-T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:423 PARK AVE
Mailing Address - Street 2:
Mailing Address - City:HUNTINGTON
Mailing Address - State:NY
Mailing Address - Zip Code:11743-2803
Mailing Address - Country:US
Mailing Address - Phone:631-271-3591
Mailing Address - Fax:631-271-5497
Practice Address - Street 1:423 PARK AVE
Practice Address - Street 2:
Practice Address - City:HUNTINGTON
Practice Address - State:NY
Practice Address - Zip Code:11743-2803
Practice Address - Country:US
Practice Address - Phone:631-271-3591
Practice Address - Fax:631-271-5497
Is Sole Proprietor?:No
Enumeration Date:2010-08-20
Last Update Date:2010-08-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)