Provider Demographics
NPI:1700614393
Name:UMOJA PSYCHOTHERAPY LCSW PLLC
Entity type:Organization
Organization Name:UMOJA PSYCHOTHERAPY LCSW PLLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:OWNER/THERAPIST
Authorized Official - Prefix:
Authorized Official - First Name:TASHI
Authorized Official - Middle Name:M
Authorized Official - Last Name:SELF
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:516-455-5195
Mailing Address - Street 1:35 SCHLEIGEL BLVD
Mailing Address - Street 2:
Mailing Address - City:FARMINGDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11735-6224
Mailing Address - Country:US
Mailing Address - Phone:516-455-5195
Mailing Address - Fax:
Practice Address - Street 1:35 SCHLEIGEL BLVD
Practice Address - Street 2:
Practice Address - City:FARMINGDALE
Practice Address - State:NY
Practice Address - Zip Code:11735-6224
Practice Address - Country:US
Practice Address - Phone:516-455-5195
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2024-07-24
Last Update Date:2024-07-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty