Provider Demographics
NPI:1144302548
Name:MAY, BRUCE (LCSW)
Entity type:Individual
Prefix:MR
First Name:BRUCE
Middle Name:
Last Name:MAY
Suffix:
Gender:M
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:320 PALMER TER
Mailing Address - Street 2:SUITE 1-D
Mailing Address - City:MAMARONECK
Mailing Address - State:NY
Mailing Address - Zip Code:10543-2428
Mailing Address - Country:US
Mailing Address - Phone:646-483-8353
Mailing Address - Fax:
Practice Address - Street 1:320 PALMER TER
Practice Address - Street 2:SUITE 1-D
Practice Address - City:MAMARONECK
Practice Address - State:NY
Practice Address - Zip Code:10543-2428
Practice Address - Country:US
Practice Address - Phone:646-483-8353
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-10-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY070340-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical