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Attention Therapists and Agencies
To Become a Preschool Special Education Related Services Only Provider for Children Ages Three to Five Years Old:
Individuals and agencies that would like to contract with the Nassau County Department of Health to provide services for Nassau County Preschool Special Education students can start the contract process by using the links below to download the Contract Request Data Sheet, the State Central Register Database Check for Child Abuse (SCR) form, the Request for Taxpayer ID-700 form, and the Debarment form. Nassau County will process the SCR on behalf of the applicant(s).
Request for Taxpayer ID- 700 Form
Please forward resume and copy of license or certification along with completed forms to:
Nassau County Department of Health
Office of Children with Special Needs
Preschool Special Education Program
Attention: Contracts
60 Charles Lindbergh Blvd, Suite 100
Uniondale, NY 11553-3683
To Become a New York State Approved Preschool Special Education 4410 Evaluation Agency, 4410 Special Education Itinerant Teacher (SEIT) Agency, and/or 4410 Center Based Program for Children Ages Three to Five Years Old see below:
Agency providers of Preschool Special Education evaluation, SEIT services, and Center Based programs are approved by New York State Department of Education (NYSED) and contracted with the local municipalities. Therefore, these providers must use the NYSED link below to obtain information and an application to become a NYSED approved 4410 Provider PRIOR to contracting with Nassau County.
http://www.p12.nysed.gov/specialed/applications/preschool-home.html
For further information, contact the Education Preschool Policy Unit at (518) 473-6108 or the SEQA Regional Office in your region:
Long Island Regional Office: (631) 952-3352
New York City Regional Office(718) 722-4544
Once the agency has obtained the NYSED 4410 approval, the agency can start the contract process by using the links below to download the Contract Request Data Sheet, the State Central Register Database Check for Child Abuse (SCR) form, the Request for Taxpayer ID-700 form, and the Debarment form. Nassau County will process the SCR on behalf of the applicant(s).
Request for Taxpayer ID- 700 Form
Please forward resume and copy of license or certification along with completed forms to:
Nassau County Department of Health
Office of Children with Special Needs
Preschool Special Education Program
Attention: Contracts
60 Charles Lindbergh Blvd, Suite 100
Uniondale, NY 11553-3683
For Agencies to become a Related Services and 4410 Provider:
Once the agency has obtained the NYSED 4410 approval, the agency can request a contract application to provide Related Services in addition to 4410 approved evaluations, SEIT, and/or Center Based programs by using the link below to download the Contract Request Data Sheet and the State Central Register Database Check for Child Abuse (SCR) form. Nassau County will process the SCR on behalf of the applicant(s).
Request for Taxpayer ID- 700 Form
Please forward resume and copy of license or certification along with completed forms to:
Nassau County Department of Health
Office of Children with Special Needs
Preschool Special Education Program
Attention: Contracts
60 Charles Lindbergh Blvd, Suite 100
Uniondale, NY 11553-3683