MLC Early Consulting Services

Primary specialty

Early Intervention Provider AgencyTaxonomy code 252Y00000X

Legal business name

MLC EARLY CONSULTING SERVICES

Practice address

390 Vernon Ave
Staten Island, NY 10309-3045

Phone

(718) 962-5829

NPI assigned

Jan 8, 2018

Organization subpart

No

Registry information is reported by the provider to CMS and is not verified. About this source

Authorized official

Name

Ms. Celenia Bonifacio, MS SPED

Title

Owner

Phone

(718) 962-5829

Specialties & licenses 2

Addresses

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1515369600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1515369600000",
    "number": "1861909129",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 VERNON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103093045",
            "telephone_number": "718-962-5829"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 VERNON AVE",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103093045",
            "telephone_number": "718-962-5829"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MLC EARLY CONSULTING SERVICES",
        "organizational_subpart": "NO",
        "enumeration_date": "2018-01-08",
        "last_updated": "2018-01-08",
        "status": "A",
        "authorized_official_last_name": "BONIFACIO",
        "authorized_official_first_name": "CELENIA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "718-962-5829",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "MS SPED"
    },
    "taxonomies": [
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": "NY",
            "license": null,
            "primary": true
        },
        {
            "code": "252Y00000X",
            "taxonomy_group": "",
            "desc": "Early Intervention Provider Agency",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 8, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.