Provider Demographics
NPI:1407352081
Name:BREEN, BRIDGET MARY (LMHC)
Entity type:Individual
Prefix:MS
First Name:BRIDGET
Middle Name:MARY
Last Name:BREEN
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:17 W CEDAR ST
Mailing Address - Street 2:
Mailing Address - City:ISLIP
Mailing Address - State:NY
Mailing Address - Zip Code:11751-1801
Mailing Address - Country:US
Mailing Address - Phone:631-459-6716
Mailing Address - Fax:
Practice Address - Street 1:17 W CEDAR ST
Practice Address - Street 2:
Practice Address - City:ISLIP
Practice Address - State:NY
Practice Address - Zip Code:11751-1801
Practice Address - Country:US
Practice Address - Phone:631-459-6716
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-04-03
Last Update Date:2025-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005249-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health