# NEUROSPROUT ABA MD LLC

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- **Entity:** Organization
- **Status:** Active
- **Organization subpart:** No

## Provider details

- **NPI number:** 1659164358
- **Authorized official:** YITZCHAK SELEH (CEO)
- **Authorized official phone:** (213) 333-4433

## Contact information

- **Practice address:** 1301 YORK RD STE 800-1030, LUTHERVILLE, MD 21093-6035
- **Practice address phone:** (213) 332-8893
- **Mailing address:** 8 KIELT WAY BSMT, LAKEWOOD, NJ 08701-5097
- **Mailing address phone:** (410) 357-1180

## Taxonomy

| Code | Description | License number | State | Primary |
| --- | --- | --- | --- | --- |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | NULL | Yes |
| 363LP0808X | Psychiatric/Mental Health Nurse Practitioner | — | — | Yes |

## Other

- **Enumeration date:** 05/26/2025
- **Last updated:** 09/09/2025