Doctor Name: | MR. TAHARKA SANKARA |
NPI Number: | 1043553829 |
Entity Type Code: | Individual (1) |
Gender: | M |
Credentials: | LCSW, LCADC |
License Number: | 37LC00174900 |
Business Practice Address: | 36 Shrewsbury Dr Long Branch, NJ - 077407619 |
Business Phone Number: | 7322721340 |
Business Fax Number: | 7322721390 |
Mailing Address: | 36 Shrewsbury Dr, LONG BRANCH |
State: | NJ |
Postal Code: | 077407619 |
Phone Number: | 7323378323 |
Fax Number: | |
NPI Enumeration Date: | 03/31/2013 |
NPI Last Update Date: | 03/07/2016 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 101YA0400X |
License Number: | 37LC00174900 |
Healthcare Provider Taxonomy: (Secondary) | N |
State: | NJ |
Taxonomy Type: | Behavioral Health & Social Service Providers |
Taxonomy Classification: | Counselor |
Taxonomy Specialization: | Addiction (Substance Use Disorder) |
Taxonomy Definition: |