Provider Demographics
NPI:1477360295
Name:GUIDED GROWTH ABA NY LLC
Entity type:Organization
Organization Name:GUIDED GROWTH ABA NY LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:BACB
Authorized Official - Prefix:MRS
Authorized Official - First Name:SORA
Authorized Official - Middle Name:FAIGA
Authorized Official - Last Name:ENOCK
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:732-674-9863
Mailing Address - Street 1:1651 E 23RD ST
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11229-1518
Mailing Address - Country:US
Mailing Address - Phone:323-241-2919
Mailing Address - Fax:
Practice Address - Street 1:1651 E 23RD ST
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11229-1518
Practice Address - Country:US
Practice Address - Phone:323-241-2919
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-12-16
Last Update Date:2024-12-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty