Provider records sourced from NPPES (CMS National Plan & Provider Enumeration System). Data current as of August 10, 2026.

Sole Proprietor

Organization Community/Behavioral Health Agency · NPI 1891187852

Sole Proprietor is a Community/Behavioral Health Agency in Williston Park, New York. Licensed in New York. Registered with an NPI since 2015.

Licensed in
NY
In the registry since
2015

Practice location Address checks out

610 Willis Ave Apt 1F
Williston Park, NY 11596-1221
Phone: (516) 770-2383
Show map & directions

Pin is approximate — placed at the ZIP-code centre, not the exact door.

Specialties & licences

Community/Behavioral Health Agency (primary) Taxonomy 251S00000X · Licence 437022101 (NY)

Record details

NPI number1891187852
Entity typeOrganization (Type 2)
Organization subpartNo
Authorized official Brendan Canavan — Abss · (516) 770-2383
NPI enumeratedFebruary 28, 2015
Last updated in NPPESFebruary 28, 2015
Mailing address610 Willis Ave Apt 1f, Williston Park, NY 11596-1221

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