Active NPI
Takia Shonte Tate, CASAC
- Addiction (Substance Use Disorder) Counselor
- Jamaica, NY
National Provider Identifier
1235934290
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Addiction (Substance Use Disorder) Counselor
- License
- 37434
- Practice address
- 17515 Rockaway Blvd RM 162
Jamaica, NY 11434-5503 - Phone
- (718) 356-5100
- Fax
- (718) 356-3155
- NPI assigned
- Feb 14, 2025
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Addiction (Substance Use Disorder) Counselor | 101YA0400X | 37434 | NY | Primary |
Addresses
Primary practice location
17515 Rockaway Blvd RM 162
Jamaica, NY 11434-5503
Mailing address
4442 Arthur Kill Rd Ste 4
Staten Island, NY 10309-1321
Phone (718) 356-5100
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 37434 | NY | MD | General Practice Dentistry |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Camelot of Staten Island, Inc. | Addiction (Substance Use Disorder) | Past | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.
-
- Addiction (Substance Use Disorder) Counselor
- Staten Island, NY
- NPI 1942359476
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1739491200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1739491200000",
"number": "1235934290",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "4442 ARTHUR KILL RD STE 4",
"city": "STATEN ISLAND",
"state": "NY",
"postal_code": "103091321",
"telephone_number": "718-356-5100",
"fax_number": "718-356-3155"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "17515 ROCKAWAY BLVD RM 162",
"city": "JAMAICA",
"state": "NY",
"postal_code": "114345503",
"telephone_number": "718-356-5100",
"fax_number": "718-356-3155"
}
],
"practiceLocations": [],
"basic": {
"last_name": "TATE",
"first_name": "TAKIA",
"middle_name": "SHONTE",
"credential": "CASAC",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2025-02-14",
"last_updated": "2025-02-14",
"certification_date": "2025-02-13",
"status": "A"
},
"taxonomies": [
{
"code": "101YA0400X",
"taxonomy_group": "",
"desc": "Counselor, Addiction (Substance Use Disorder)",
"state": "NY",
"license": "37434",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in Jamaica, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 14, 2025; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.