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Individual

TEJASWI BISTA

Active
Sole proprietor
No

Provider details

NPI number
Gender
F
Credential
CASAC-T

Contact information

Practice address
13020 89TH RD, JAMAICA, NY 11418-3301
(718) 441-8913
Mailing address
8438 57TH RD, ELMHURST, NY 11373-4841
(516) 737-6531

Taxonomy

Speciality
Code
Description
License number
State
101YA0400X
Addiction (Substance Use Disorder) Counselor
Primary
39349
NY

Other

Enumeration date
04/29/2026
Last updated
04/29/2026
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