Provider Demographics
NPI:1659183259
Name:SOPHISTICATED FRIENDS LLC
Entity type:Organization
Organization Name:SOPHISTICATED FRIENDS LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EARLY INTERVENTION DIRECTOR/ PROVID
Authorized Official - Prefix:
Authorized Official - First Name:SOPHIE
Authorized Official - Middle Name:
Authorized Official - Last Name:LOUIS
Authorized Official - Suffix:
Authorized Official - Credentials:SPED
Authorized Official - Phone:718-399-7277
Mailing Address - Street 1:25 LEFFERTS AVE APT 2Z
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11225-3941
Mailing Address - Country:US
Mailing Address - Phone:718-799-2233
Mailing Address - Fax:
Practice Address - Street 1:25 LEFFERTS AVE APT 2Z
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11225-3941
Practice Address - Country:US
Practice Address - Phone:718-799-2233
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-01-22
Last Update Date:2025-01-22
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes252Y00000XAgenciesEarly Intervention Provider Agency