Healthcare Provider Details

I. General information

NPI: 1679459531
Provider Name (Legal Business Name): RISING CHILD CENTER
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/14/2025
Last Update Date: 08/14/2025
Certification Date: 08/14/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

681 CHESTNUT RIDGE RD BLDG 4
SPRING VALLEY NY
10977-6200
US

IV. Provider business mailing address

12 MAPLE LEAF RD
MONSEY NY
10952-3030
US

V. Phone/Fax

Practice location:
  • Phone: 845-400-9870
  • Fax: 845-367-9870
Mailing address:
  • Phone: 718-541-2637
  • Fax: 845-367-9870

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code103TC1900X
TaxonomyCounseling Psychologist
License Number
License Number State

VIII. Authorized Official

Name: YITZCHOK BIRNHACK
Title or Position: ADMINISTRATOR
Credential:
Phone: 845-400-9870