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 1184041998

Bridge Back to Life Center, Inc provides Clinical Social Worker services in Brooklyn, New York. Licensed in New York. Registered with an NPI since 2014.

Licensed in
NY
In the registry since
2014
Specialties on file
2
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

3044 Coney Island Ave 3rd Fl
Brooklyn, NY 11235-5660
Phone: (718) 265-4200
Fax: (718) 265-8536
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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 141111254 (NY)
Addiction (Substance Use Disorder) Registered Nurse Taxonomy 163WA0400X · Licence 141111254 (NY)

Record details

NPI number1184041998
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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