Healthcare Provider Details

I. General information

NPI: 1235206327
Provider Name (Legal Business Name): AREBA CASRIEL, INC.
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 11/30/2006
Last Update Date: 05/04/2022
Certification Date: 05/04/2022
Deactivation Date:
Reactivation Date:

III. Provider practice location address

589 ROCKAWAY AVE
BROOKLYN NY
11212-5624
US

IV. Provider business mailing address

589 ROCKAWAY AVE
BROOKLYN NY
11212-5624
US

V. Phone/Fax

Practice location:
  • Phone: 212-293-3000
  • Fax: 646-517-7905
Mailing address:
  • Phone: 212-293-3000
  • Fax: 646-517-7905

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number091211439
License Number StateNY
# 2
Primary TaxonomyN
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number091211439
License Number StateNY
# 3
Primary TaxonomyN
Taxonomy Code103TA0400X
TaxonomyAddiction (Substance Use Disorder) Psychologist
License Number061211439
License Number StateNY
# 4
Primary TaxonomyN
Taxonomy Code163W00000X
TaxonomyRegistered Nurse
License Number061211447
License Number StateNY
# 5
Primary TaxonomyN
Taxonomy Code163WA0400X
TaxonomyAddiction (Substance Use Disorder) Registered Nurse
License Number061211439
License Number StateNY
# 6
Primary TaxonomyN
Taxonomy Code164W00000X
TaxonomyLicensed Practical Nurse
License Number061211447
License Number StateNY
# 7
Primary TaxonomyN
Taxonomy Code246RP1900X
TaxonomyPhlebotomy Technician
License Number061211439
License Number StateNY
# 8
Primary TaxonomyN
Taxonomy Code261Q00000X
TaxonomyClinic/Center
License Number080810643
License Number StateNY
# 9
Primary TaxonomyN
Taxonomy Code261QR0405X
TaxonomySubstance Use Disorder Rehabilitation Clinic/Center
License Number080810643
License Number StateNY
# 10
Primary TaxonomyY
Taxonomy Code324500000X
TaxonomySubstance Abuse Rehabilitation Facility
License Number061211447
License Number StateNY
# 11
Primary TaxonomyN
Taxonomy Code363L00000X
TaxonomyNurse Practitioner
License Number061211439
License Number StateNY
# 12
Primary TaxonomyN
Taxonomy Code363LA2200X
TaxonomyAdult Health Nurse Practitioner
License Number061211447
License Number StateNY
# 13
Primary TaxonomyN
Taxonomy Code363LF0000X
TaxonomyFamily Nurse Practitioner
License Number061211439
License Number StateNY
# 14
Primary TaxonomyN
Taxonomy Code363LP0808X
TaxonomyPsychiatric/Mental Health Nurse Practitioner
License Number061211439
License Number StateNY

VIII. Authorized Official

Name: MRS. HAWA U. JALLOH
Title or Position: CHIEF EXECUTIVE OFFICER
Credential: LMSW, M-CASAC
Phone: 212-293-3000