Provider Demographics
NPI:1518508118
Name:GOLDENSTEIN, DANIELLA E (BCBA)
Entity type:Individual
Prefix:
First Name:DANIELLA
Middle Name:E
Last Name:GOLDENSTEIN
Suffix:
Gender:F
Credentials:BCBA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:98 BIRCH LN
Mailing Address - Street 2:
Mailing Address - City:WOODMERE
Mailing Address - State:NY
Mailing Address - Zip Code:11598-2207
Mailing Address - Country:US
Mailing Address - Phone:646-945-2915
Mailing Address - Fax:
Practice Address - Street 1:341 TRINITY ST
Practice Address - Street 2:
Practice Address - City:MALVERNE
Practice Address - State:NY
Practice Address - Zip Code:11565-1234
Practice Address - Country:US
Practice Address - Phone:516-229-1194
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-10-04
Last Update Date:2024-08-14
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
106S00000X
NY1-24-74370103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst
No106S00000XBehavioral Health & Social Service ProvidersBehavior Technician