Healthcare Provider Details

I. General information

NPI: 1881552883
Provider Name (Legal Business Name): MY WAY BEHAVIORAL HEALTH LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 01/10/2026
Last Update Date: 01/10/2026
Certification Date: 01/10/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

50 LAUREL ST
FLORAL PARK NY
11001-2824
US

IV. Provider business mailing address

50 LAUREL ST
FLORAL PARK NY
11001-2824
US

V. Phone/Fax

Practice location:
  • Phone: 917-334-2903
  • Fax:
Mailing address:
  • Phone: 917-334-2903
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State

VIII. Authorized Official

Name: NICOLETTA SKLAVOUNAKIS
Title or Position: FOUNDER
Credential: LMSW, LBA, BCBA, IBA
Phone: 917-334-2903