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Search › New York › 104100000X

Matthew Bacca, LSW

NPI 1538825922 · on the registry since 2021

Practice

Address
11050 Mount Belvedere Blvd
Fort Drum, NY 13602
Phone
(719) 634-8365
Organisation at this address
Us Army
Ahc Guthrie-Drum
Inferred from a shared address, not stated in the registry.
Clinicians at this address
155

Registry record

Primary taxonomy
104100000X
104100000X
Licence states on file
CO
From the registry's licence fields, which are often incomplete.
Sex
Male
Record last updated
2025-08-11

Source: CMS National Plan and Provider Enumeration System. Registration is not the same as practising, and the registry records no retirement — some people listed here no longer practise. More in New York