Provider Demographics
NPI:1043611841
Name:BOTTE, YASMIN ROSE (LMHC)
Entity Type:Individual
Prefix:
First Name:YASMIN
Middle Name:ROSE
Last Name:BOTTE
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:526 AMHERST AVE
Mailing Address - Street 2:
Mailing Address - City:STATEN ISLAND
Mailing Address - State:NY
Mailing Address - Zip Code:10306-5325
Mailing Address - Country:US
Mailing Address - Phone:347-948-5077
Mailing Address - Fax:347-394-2152
Practice Address - Street 1:345 GUYON AVENUE
Practice Address - Street 2:ROOM 14
Practice Address - City:STATEN ISLAND
Practice Address - State:NY
Practice Address - Zip Code:10306-5306
Practice Address - Country:US
Practice Address - Phone:347-948-5077
Practice Address - Fax:347-394-2152
Is Sole Proprietor?:Yes
Enumeration Date:2014-09-11
Last Update Date:2016-11-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health