Provider Demographics
NPI:1548682487
Name:THOMAS-RICHARDSON, TARSHA (MPA, HS-BCP, CASAC)
Entity type:Individual
Prefix:
First Name:TARSHA
Middle Name:
Last Name:THOMAS-RICHARDSON
Suffix:
Gender:F
Credentials:MPA, HS-BCP, CASAC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1953 NEREID AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10466-1247
Mailing Address - Country:US
Mailing Address - Phone:718-696-8124
Mailing Address - Fax:
Practice Address - Street 1:1953 NEREID AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10466-1247
Practice Address - Country:US
Practice Address - Phone:718-696-8124
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-01-13
Last Update Date:2014-01-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY26975101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)