Healthcare Provider Details

I. General information

NPI: 1891619995
Provider Name (Legal Business Name): MIND SET ABA LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/10/2026
Last Update Date: 08/10/2026
Certification Date: 07/30/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1078 SUMMIT AVE STE 559
JERSEY CITY NJ
07307-3438
US

IV. Provider business mailing address

16730 LEE ST
ORLAND PARK IL
60467-8709
US

V. Phone/Fax

Practice location:
  • Phone: 708-275-6104
  • Fax:
Mailing address:
  • Phone: 708-275-6104
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State

VIII. Authorized Official

Name: MISS NOHA HASAN
Title or Position: CEO
Credential: BCBA
Phone: 708-275-6104