1043710882 NPI number — YES I CAN LICENSED BEHAVIOR ANALYST PLLC

Table of content: MISS HEATHER ABREU LMHC, CRC (NPI 1306099106)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1043710882 NPI number — YES I CAN LICENSED BEHAVIOR ANALYST PLLC

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
YES I CAN LICENSED BEHAVIOR ANALYST PLLC
Provider Last Name:
Provider First Name:
Provider Middle Name:
Provider Name Prefix Text:
Provider Name Suffix Text:
Provider Credential Text:
Provider Gender Code:

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
Provider Other First Name:
Provider Other Middle Name:
Provider Other Name Prefix Text:
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:

NPI Number Information

NPI Number:
1043710882
Entity Type Code:
Organization
Replacement NPI:
Last Update Date:
06/24/2021
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
5309 18TH AVE STE 300
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
BROOKLYN
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
11204-1523
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
718-370-3033
Provider Business Mailing Address Fax Number:
718-370-3140

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
5309 18TH AVE STE 300
Provider Second Line Business Practice Location Address:
Provider Business Practice Location Address City Name:
BROOKLYN
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
11204-1523
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
718-370-3033
Provider Business Practice Location Address Fax Number:
718-370-3140
Provider Enumeration Date:
02/19/2018

Additional Information

Authorized Official

Authorized Official Last Name:
FELLER
Authorized Official First Name:
SIMCHA
Authorized Official Middle Name:
Authorized Official Title or Position:
CEO
Authorized Official Telephone Number:
718-370-3033

Provider Taxonomy Codes

  • Taxonomy code: 103K00000X ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)





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