Individual
TAKIA SHONTE TATE
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
CASAC
Contact information
Practice address
17515 ROCKAWAY BLVD RM 162, JAMAICA, NY 11434-5503
(718) 356-5100
(718) 356-3155
Mailing address
4442 ARTHUR KILL RD STE 4, STATEN ISLAND, NY 10309-1321
(718) 356-5100
(718) 356-3155
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
37434
NY
Other
Enumeration date
02/14/2025
Last updated
02/14/2025
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