Healthcare Provider Details

I. General information

NPI: 1639933971
Provider Name (Legal Business Name): STABILIZING THE MIND INC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/07/2024
Last Update Date: 02/07/2024
Certification Date: 02/07/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1228 E 84TH ST FL 1
BROOKLYN NY
11236-4912
US

IV. Provider business mailing address

1228 E 84TH ST FL 1
BROOKLYN NY
11236-4912
US

V. Phone/Fax

Practice location:
  • Phone: 347-424-2681
  • Fax:
Mailing address:
  • Phone: 347-424-2681
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251C00000X
TaxonomyDevelopmentally Disabled Services Day Training Agency
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number StateNULL
# 3
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number StateNULL
# 4
Primary TaxonomyN
Taxonomy Code251S00000X
TaxonomyCommunity/Behavioral Health Agency
License Number
License Number StateNULL

VIII. Authorized Official

Name: DEVIKA LLOLANDA VIGILANCE
Title or Position: PRESIDENT
Credential: MSED
Phone: 347-424-2681