Provider Demographics
NPI:1609409887
Name:YESODOT, INC
Entity Type:Organization
Organization Name:YESODOT, INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:SENIOR CLINICAL DIRECTOR/COFOUNDER
Authorized Official - Prefix:MRS
Authorized Official - First Name:ILANA
Authorized Official - Middle Name:
Authorized Official - Last Name:RACHNAEV
Authorized Official - Suffix:
Authorized Official - Credentials:LMSW
Authorized Official - Phone:347-617-3502
Mailing Address - Street 1:110-06 69TH AVE
Mailing Address - Street 2:
Mailing Address - City:FOREST HILLS
Mailing Address - State:NY
Mailing Address - Zip Code:11375
Mailing Address - Country:US
Mailing Address - Phone:347-617-5751
Mailing Address - Fax:
Practice Address - Street 1:110-06 69TH AVE
Practice Address - Street 2:
Practice Address - City:FOREST HILLS
Practice Address - State:NY
Practice Address - Zip Code:11375
Practice Address - Country:US
Practice Address - Phone:347-617-5751
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2020-02-17
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes251S00000XAgenciesCommunity/Behavioral Health
No261QM0801XAmbulatory Health Care FacilitiesClinic/CenterMental Health (Including Community Mental Health Center)
No261QM0850XAmbulatory Health Care FacilitiesClinic/CenterAdult Mental Health
No261QM0855XAmbulatory Health Care FacilitiesClinic/CenterAdolescent and Children Mental Health