Provider Demographics
NPI:1750150611
Name:CAELUM LLC
Entity type:Organization
Organization Name:CAELUM LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:KATHRYN
Authorized Official - Middle Name:
Authorized Official - Last Name:BI
Authorized Official - Suffix:
Authorized Official - Credentials:
Authorized Official - Phone:212-450-4887
Mailing Address - Street 1:37 NORTHERN BLVD UNIT 130
Mailing Address - Street 2:
Mailing Address - City:GREENVALE
Mailing Address - State:NY
Mailing Address - Zip Code:11548-4006
Mailing Address - Country:US
Mailing Address - Phone:646-413-8336
Mailing Address - Fax:
Practice Address - Street 1:24125 BRADDOCK AVE
Practice Address - Street 2:
Practice Address - City:BELLEROSE
Practice Address - State:NY
Practice Address - Zip Code:11426-1150
Practice Address - Country:US
Practice Address - Phone:646-413-8336
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2023-12-20
Last Update Date:2023-12-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior AnalystGroup - Single Specialty