Healthcare Provider Details

I. General information

NPI: 1326271974
Provider Name (Legal Business Name): CHILDREN FIRST SPEECH LANGUAGE PATHOLOGY AND PSYCHOLOGY PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/31/2009
Last Update Date: 09/18/2023
Certification Date: 09/18/2023
Deactivation Date:
Reactivation Date:

III. Provider practice location address

14 CONKLIN AVENUE
TAPPAN NY
10983
US

IV. Provider business mailing address

14 CONKLIN AVE
TAPPAN NY
10983-2005
US

V. Phone/Fax

Practice location:
  • Phone: 516-746-2609
  • Fax:
Mailing address:
  • Phone: 516-746-2609
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number1020796
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code103TC0700X
TaxonomyClinical Psychologist
License Number015985-1
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number011945
License Number StateNY

VIII. Authorized Official

Name: SARA MELANIE KAHN
Title or Position: DIRECTOR OF ABA SERVICES
Credential: M.A., BCBA
Phone: 845-848-2585