Healthcare Provider Details

I. General information

NPI: 1376993527
Provider Name (Legal Business Name): REACHING HIGHER, INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 06/20/2016
Last Update Date: 05/09/2017
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1068 40TH ST
BROOKLYN NY
11219-1029
US

IV. Provider business mailing address

204 CLERMONT PL
STATEN ISLAND NY
10314-5102
US

V. Phone/Fax

Practice location:
  • Phone: 718-673-6446
  • Fax: 718-673-6446
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number000427
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number000427
License Number StateNY

VIII. Authorized Official

Name: YITZCHOK KRAKAUER
Title or Position: DIRECTOR
Credential: BCBA, LBA
Phone: 718-673-6446