Provider Demographics
NPI:1982046082
Name:BATISTE-LOCKE, TAMARA DEIRDRE (PHD)
Entity Type:Individual
Prefix:
First Name:TAMARA
Middle Name:DEIRDRE
Last Name:BATISTE-LOCKE
Suffix:
Gender:F
Credentials:PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2600 SOUTH RD STE 196
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12601-7003
Mailing Address - Country:US
Mailing Address - Phone:845-204-5731
Mailing Address - Fax:
Practice Address - Street 1:2600 SOUTH RD STE 196
Practice Address - Street 2:
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12601-7003
Practice Address - Country:US
Practice Address - Phone:845-204-8731
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2013-07-18
Last Update Date:2022-08-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005264-1101YM0800X
103TC1900X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103TC1900XBehavioral Health & Social Service ProvidersPsychologistCounseling
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health