Healthcare Provider Details

I. General information

NPI: 1437561545
Provider Name (Legal Business Name): TATYANA BABAYAN LSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: TINA LEVINE-BABAYAN LCSW

II. Dates (important events)

Enumeration Date: 05/22/2014
Last Update Date: 08/01/2026
Certification Date: 08/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

317 GEORGE ST
NEW BRUNSWICK NJ
08901-2008
US

IV. Provider business mailing address

193 PINEWOOD AVE
STATEN ISLAND NY
10306-1816
US

V. Phone/Fax

Practice location:
  • Phone: 973-800-6291
  • Fax: 718-987-5672
Mailing address:
  • Phone: 718-351-3991
  • Fax: 718-987-5672

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number44SC05709500
License Number StateNJ

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: