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General NPI Number Information
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NPI Number | 1558909168
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Entity Type | Individual
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Provider Name | TAHIRAT NASIRU LCSW
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Gender | Female
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Dates
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Enumeration Date | 12/13/2019
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Last Update Date | 12/10/2024
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Provider Practice Location Address
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Address Line | 2493 ADAM CLAYTON POWELL JR BLVD
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City | NEW YORK
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State | NY
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Zip | 10030-1331
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Country | US
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Telephone | 212-678-7188
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Fax |
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Provider Business Mailing Address
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Address Line | 152 EAST 118TH STREET SUITE S1, PO BOX 1026
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City | NEW YORK
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State | NY
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Zip | 10035
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Country | US
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Telephone | 347-480-8072
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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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 | NY
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Taxonomy #2
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Taxonomy Code | 1041C0700X
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Taxonomy Name | Clinical Social Worker
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License Number | 099059
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License Number State | NY
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