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General NPI Number Information
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NPI Number | 1528668282
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Entity Type | Organization
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Legal Business Name | TATE PSYCHOTHERAPY LCSW PLLC
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Dates
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Enumeration Date | 10/30/2020
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Last Update Date | 12/14/2021
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Provider Practice Location Address
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Address Line | 116 W 23RD ST FL 5
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City | NEW YORK
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State | NY
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Zip | 10011-2599
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Country | US
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Telephone | 212-729-6034
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Fax |
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Provider Business Mailing Address
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Address Line | 116 W 23RD ST FL 5
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City | NEW YORK
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State | NY
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Zip | 10011-2599
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Country | US
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Telephone | 212-729-6034
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Fax |
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Authorized Official
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Title or Position | CEO
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Name | MARY TATE
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Credential | LCSW
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Telephone | 910-280-5577
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number |
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License Number State |
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