Provider Demographics
NPI:1447874698
Name:GOTAY-IHONOR, TARSIS DAMARIS (LMSW)
Entity type:Individual
Prefix:
First Name:TARSIS
Middle Name:DAMARIS
Last Name:GOTAY-IHONOR
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:TARSOS
Other - Middle Name:DAMARIS
Other - Last Name:GOTAY
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:730 OAKLAND PL APT 3H
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10457-3608
Mailing Address - Country:US
Mailing Address - Phone:917-572-0252
Mailing Address - Fax:
Practice Address - Street 1:3424 KOSSUTH AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10467-2410
Practice Address - Country:US
Practice Address - Phone:718-515-1504
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2020-06-03
Last Update Date:2020-06-03
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY104207104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker