Provider Demographics
NPI:1265829600
Name:BANSGOPAUL, TEKPAUL JOSEPH (LMSW)
Entity Type:Individual
Prefix:MR
First Name:TEKPAUL
Middle Name:JOSEPH
Last Name:BANSGOPAUL
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:329EAST 149TH STREET
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10451
Mailing Address - Country:US
Mailing Address - Phone:718-769-2698
Mailing Address - Fax:718-401-0108
Practice Address - Street 1:2625EAST 14TH STREET
Practice Address - Street 2:200
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11235
Practice Address - Country:US
Practice Address - Phone:718-769-2698
Practice Address - Fax:718-401-0108
Is Sole Proprietor?:Yes
Enumeration Date:2015-04-23
Last Update Date:2015-04-23
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker