Organization
IN SPROUT MC 1 LLC
Active
Other names
Sprout Therapy, Elemy
Organization subpart
No
Provider details
NPI number
Authorized official
YURY YAKUBCHYK SR. (OWNER)
(317) 647-4173
Entity
Organization
Contact information
Practice address
201 N ILLINOIS ST FL 16, INDIANAPOLIS, IN 46204-1904
(833) 991-2368
(929) 384-7193
Mailing address
19 W 24TH ST FL 4, NEW YORK, NY 10010-3239
(833) 458-0386
(855) 461-3542
Taxonomy
Speciality
Code
Description
License number
State
103K00000X
Behavior Analyst
Primary
—
—
Other
Enumeration date
04/15/2020
Last updated
07/28/2025
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