Provider Demographics
NPI:1265093421
Name:KUFEJI, TEMITOPE (LCSW)
Entity type:Individual
Prefix:
First Name:TEMITOPE
Middle Name:
Last Name:KUFEJI
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 1:459 BEACH 68TH ST # 2
Mailing Address - Street 2:
Mailing Address - City:ARVERNE
Mailing Address - State:NY
Mailing Address - Zip Code:11692-1406
Mailing Address - Country:US
Mailing Address - Phone:917-535-2091
Mailing Address - Fax:
Practice Address - Street 1:459 BEACH 68TH ST # 2
Practice Address - Street 2:
Practice Address - City:ARVERNE
Practice Address - State:NY
Practice Address - Zip Code:11692-1406
Practice Address - Country:US
Practice Address - Phone:917-535-2091
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2019-06-27
Last Update Date:2019-06-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0808201041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical