Healthcare Provider Details

I. General information

NPI: 1699607994
Provider Name (Legal Business Name): YASMIN ABDELGADIR ABDELGADIR CASAC-T
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 06/01/2026
Last Update Date: 06/01/2026
Certification Date: 06/01/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15 2ND AVE
BROOKLYN NY
11215-2711
US

IV. Provider business mailing address

6803 4TH AVE STE 1
BROOKLYN NY
11220-9993
US

V. Phone/Fax

Practice location:
  • Phone: 718-514-6007
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101YA0400X
TaxonomyAddiction (Substance Use Disorder) Counselor
License Number41415
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: