Healthcare Provider Details

I. General information

NPI: 1073054961
Provider Name (Legal Business Name): ENABLE MY CHILD LTD.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 03/13/2017
Last Update Date: 09/12/2025
Certification Date: 09/12/2025
Deactivation Date:
Reactivation Date:

III. Provider practice location address

22411 N OAK STREET SUITE 301L
MYRTLE BEACH SC
29577-3165
US

IV. Provider business mailing address

26 HILL ST # 115
SOUTHAMPTON NY
11968-5317
US

V. Phone/Fax

Practice location:
  • Phone: 888-511-7930
  • Fax:
Mailing address:
  • Phone: 888-511-7930
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code2251P0200X
TaxonomyPediatric Physical Therapist
License Number
License Number State
# 4
Primary TaxonomyN
Taxonomy Code225XP0200X
TaxonomyPediatric Occupational Therapist
License Number
License Number State
# 5
Primary TaxonomyN
Taxonomy Code235Z00000X
TaxonomySpeech-Language Pathologist
License Number
License Number State
# 6
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number
License Number State

VIII. Authorized Official

Name: SYED MOHAMMED
Title or Position: CEO
Credential:
Phone: 917-407-6499