Provider Demographics
NPI:1013566157
Name:CASIMIR, TATIANA KENDRA (LMSW)
Entity Type:Individual
Prefix:
First Name:TATIANA
Middle Name:KENDRA
Last Name:CASIMIR
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1007 QUENTIN RD
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-2341
Mailing Address - Country:US
Mailing Address - Phone:718-998-3235
Mailing Address - Fax:718-336-3040
Practice Address - Street 1:1007 QUENTIN RD
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-2341
Practice Address - Country:US
Practice Address - Phone:718-998-3235
Practice Address - Fax:718-336-3040
Is Sole Proprietor?:No
Enumeration Date:2019-09-11
Last Update Date:2021-03-07
Deactivation Date:2020-05-29
Deactivation Code:
Reactivation Date:2021-02-26
Provider Licenses
StateLicense IDTaxonomies
NY1059271041S0200X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041S0200XBehavioral Health & Social Service ProvidersSocial WorkerSchool