MEDICARE: SPECIAL MINDS INC

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	252Y00000X	Early Intervention Provider Agency

General Provider Information

NPI Number	:	1093396061
Entity Type Code	:	Organization
Provider Name (Legal Business Name)	:	SPECIAL MINDS INC

Provider Business Mailing Address
First Line	:	305 KENNEDY DR
Second Line	:
City	:	SPRING VALLEY
State	:	NY
Zip	:	10977-6065
Country	:	US
Telephone Number	:	845-729-0417
Fax Number	:

Provider Business Practice Location Address
First Line	:	305 KENNEDY DR
Second Line	:
City	:	SPRING VALLEY
State	:	NY
Zip	:	10977-6065
Country	:	US
Telephone Number	:	845-729-0417
Fax Number	:

Authorized Official
Title or Position	:	CEO
Name	:	MRS. OLGA KARAVATSKI
Credential	:	MSED
Telephone Number	:	845-729-0417

Provider Enumeration Date	:	04/20/2021
Last Update Date	:	04/20/2021

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Directions to “SPECIAL MINDS INC ” Practice Location

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