Provider Demographics
NPI:1942757273
Name:TABOR, ADINA SARA (LCSW)
Entity Type:Individual
Prefix:
First Name:ADINA
Middle Name:SARA
Last Name:TABOR
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:95 N 7TH ST APT 2R
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11249-3017
Mailing Address - Country:US
Mailing Address - Phone:240-505-6283
Mailing Address - Fax:
Practice Address - Street 1:260 MADISON AVE STE 8051
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2401
Practice Address - Country:US
Practice Address - Phone:646-661-3840
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-09-02
Last Update Date:2024-04-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY093897104100000X
NY0883751041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
No104100000XBehavioral Health & Social Service ProvidersSocial Worker