Healthcare Provider Details

I. General information

NPI: 1740329531
Provider Name (Legal Business Name): CENTRAL NASSAU GUIDANCE & COUNSELING SERVICES, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 02/06/2007
Last Update Date: 04/09/2025
Certification Date: 04/09/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

55 W AMES CT
PLAINVIEW NY
11803-2304
US

IV. Provider business mailing address

950 S OYSTER BAY RD
HICKSVILLE NY
11801-3510
US

V. Phone/Fax

Practice location:
  • Phone: 516-822-1111
  • Fax:
Mailing address:
  • Phone: 516-822-6111
  • Fax: 516-536-0553

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number
License Number State
# 2
Primary TaxonomyY
Taxonomy Code320800000X
TaxonomyMental Illness Community Based Residential Treatment Facility
License Number01303520
License Number StateNY

VII. Legacy identifiers

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

# 1
Identifier01303520
Identifier TypeMEDICAID
Identifier StateNY
Identifier Issuer

VIII. Authorized Official

Name: JEFFREY FRIEDMAN
Title or Position: CEO
Credential:
Phone: 516-822-6111