Healthcare Provider Details

I. General information

NPI: 1932837382
Provider Name (Legal Business Name): ATLAS KIDS & FAMILY THERAPY
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/12/2022
Last Update Date: 01/17/2023
Certification Date: 01/17/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

105 WESTBURY AVE
PLAINVIEW NY
11803-3616
US

IV. Provider business mailing address

105 WESTBURY AVE
PLAINVIEW NY
11803-3616
US

V. Phone/Fax

Practice location:
  • Phone: 516-455-2804
  • Fax:
Mailing address:
  • Phone: 516-455-2804
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code251B00000X
TaxonomyCase Management Agency
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code252Y00000X
TaxonomyEarly Intervention Provider Agency
License Number
License Number State

VII. Legacy identifiers

For crosswalk purposes, the following legacy (non-NPI) identifiers are available for this provider:

VIII. Authorized Official

Name: DR. JOEL LEVINE
Title or Position: EXECUTIVE DIRECTOR
Credential: PHD
Phone: 516-455-2804