Provider Demographics
NPI:1093273930
Name:SPECIAL ED FOR SPECIAL KIDS, INC.
Entity Type:Organization
Organization Name:SPECIAL ED FOR SPECIAL KIDS, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:PRESIDENT
Authorized Official - Prefix:MRS
Authorized Official - First Name:BECKI
Authorized Official - Middle Name:NAOMI
Authorized Official - Last Name:BOUSSIDAN
Authorized Official - Suffix:
Authorized Official - Credentials:MS ED
Authorized Official - Phone:917-783-5340
Mailing Address - Street 1:7 VERNON ST
Mailing Address - Street 2:
Mailing Address - City:PLAINVIEW
Mailing Address - State:NY
Mailing Address - Zip Code:11803-4603
Mailing Address - Country:US
Mailing Address - Phone:917-783-5340
Mailing Address - Fax:516-935-2867
Practice Address - Street 1:7 VERNON ST
Practice Address - Street 2:
Practice Address - City:PLAINVIEW
Practice Address - State:NY
Practice Address - Zip Code:11803-4603
Practice Address - Country:US
Practice Address - Phone:917-783-5340
Practice Address - Fax:516-935-2867
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2019-03-11
Last Update Date:2019-03-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental HealthGroup - Single Specialty