Provider Demographics
NPI:1942053830
Name:JULIEN, ABANA NATAFA (CASAC- T)
Entity Type:Individual
Prefix:
First Name:ABANA
Middle Name:NATAFA
Last Name:JULIEN
Suffix:
Gender:F
Credentials:CASAC- T
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2581 ATLANTIC AVE FL 2
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11207-2412
Mailing Address - Country:US
Mailing Address - Phone:646-556-5324
Mailing Address - Fax:718-260-8137
Practice Address - Street 1:2581 ATLANTIC AVE FL 2
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11207-2412
Practice Address - Country:US
Practice Address - Phone:646-556-5324
Practice Address - Fax:718-260-8137
Is Sole Proprietor?:Yes
Enumeration Date:2024-04-09
Last Update Date:2024-04-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty