Healthcare Provider Details

I. General information

NPI: 1831685445
Provider Name (Legal Business Name): TAREN A WEST LMSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 07/06/2018
Last Update Date: 07/06/2018
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

15813 72ND AVE
FRESH MEADOWS NY
11365-1140
US

IV. Provider business mailing address

220 W 167TH ST APT 6D
BRONX NY
10452-4140
US

V. Phone/Fax

Practice location:
  • Phone: 718-380-7600
  • Fax:
Mailing address:
  • Phone: 646-670-8652
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code104100000X
TaxonomySocial Worker
License Number
License Number StateNULL
# 2
Primary TaxonomyN
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number StateNULL
# 3
Primary TaxonomyN
Taxonomy Code103K00000X
TaxonomyBehavior Analyst
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: