Individual
TANYA BATES
Active
Sole proprietor
Yes
Provider details
NPI number
Gender
F
Credential
B.A./CASAC-T/NYSCNA
Contact information
Practice address
15 S 27TH ST, WYANDANCH, NY 11798-3705
(347) 650-8233
Mailing address
15 SOUTH 27TH STREET, WYANDANCH, NY 11799-0000
(334) 765-0823
Taxonomy
Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
—
NY
101YP2500X
Professional Counselor
—
NY
171W00000X
Contractor
342004610703E
NY
251V00000X
Voluntary or Charitable Agency
Primary
—
NY
390200000X
Student in an Organized Health Care Education/Training Program
342004610703E
NY
Other
Other identifiers
Code
Description
Identifier
Issuer
State
01
—
342004610703E
NYS-CNA, HHA
NY
Enumeration date
04/19/2007
Last updated
09/17/2014
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