Provider Demographics
NPI:1902611593
Name:BSEB-BIRTH SUPPORT, EDUCATION & BEYOND, INC.
Entity type:Organization
Organization Name:BSEB-BIRTH SUPPORT, EDUCATION & BEYOND, INC.
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:EXECUTIVE DIRECTOR
Authorized Official - Prefix:
Authorized Official - First Name:TRACI
Authorized Official - Middle Name:
Authorized Official - Last Name:MCCOMISKEY
Authorized Official - Suffix:
Authorized Official - Credentials:CD, CCE, CHW, PMH-C,
Authorized Official - Phone:860-867-7541
Mailing Address - Street 1:15 CROSSLEY CT
Mailing Address - Street 2:
Mailing Address - City:NIANTIC
Mailing Address - State:CT
Mailing Address - Zip Code:06357-2342
Mailing Address - Country:US
Mailing Address - Phone:860-867-7541
Mailing Address - Fax:
Practice Address - Street 1:15 CROSSLEY COURT
Practice Address - Street 2:
Practice Address - City:NIANTIC
Practice Address - State:CT
Practice Address - Zip Code:06357-2342
Practice Address - Country:US
Practice Address - Phone:860-867-7541
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2025-02-11
Last Update Date:2025-02-11
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes374J00000XNursing Service Related ProvidersDoulaGroup - Multi-Specialty
No172V00000XOther Service ProvidersCommunity Health WorkerGroup - Multi-Specialty