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General NPI Number Information
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NPI Number | 1689155814
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Entity Type | Individual
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Provider Name | MR. SOSTENES BATISTA LIMA
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Gender | Male
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Dates
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Enumeration Date | 08/26/2018
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Last Update Date | 09/26/2019
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Provider Practice Location Address
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Address Line | 35-25 86TH ST APT 1F
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City | JACKSON HEIGHTS
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State | NY
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Zip | 11372
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Country | US
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Telephone | 704-604-1299
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Fax |
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Provider Business Mailing Address
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Address Line | 3455 PERCY ST
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City | LOS ANGELES
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State | CA
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Zip | 90023-1716
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Country | US
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Telephone | 704-604-1299
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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 | 104100000X
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Taxonomy Name | Social Worker
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License Number |
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License Number State |
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Taxonomy #2
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Taxonomy Code | 101YM0800X
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Taxonomy Name | Mental Health Counselor
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License Number | 90546
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License Number State | CA
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