Tanya Isdith-Collado, LMSW

Individual provider Active NPI Clinical Social Worker · Corona, NY

NPI 1801029236 · NPPES record last updated Jul 30, 2024

Key facts

NPI
1801029236
Entity type
Individual (NPI type 1)
Primary specialty
Clinical Social Worker 1041C0700X
License
087373 (NY)
Practice address
10324 Corona Ave
Corona, NY 11368-3177
Phone
(929) 522-0952
NPI assigned
Sep 2, 2009
Sex
Female
Sole proprietor
Yes

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.

Medicare participation

Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

Medicare enrollment (NPD)
No

State licenses

LicenseStateTypeSpecialty
087373NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
1 Integral Mental Health Counseling Practice PLLC Past
since Aug 4, 2024
Accepting new patients

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 087373 NY Yes

Addresses

Primary practice location

10324 Corona Ave
Corona, NY 11368-3177

Mailing address

25 Suydam St
Brooklyn, NY 11221-2509
Phone (917) 939-8426

Other providers in Corona, NY

All providers in Corona, NY · Clinical Social Worker in New York

Sources for this page

Verify at the official NPI Registry.