Provider Demographics
NPI:1386326288
Name:ROJAS, THALIA
Entity type:Individual
Prefix:
First Name:THALIA
Middle Name:
Last Name:ROJAS
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:8214 31ST AVE FL 1
Mailing Address - Street 2:
Mailing Address - City:EAST ELMHURST
Mailing Address - State:NY
Mailing Address - Zip Code:11370-3370
Mailing Address - Country:US
Mailing Address - Phone:516-474-1297
Mailing Address - Fax:
Practice Address - Street 1:4322 50TH ST STE 2C
Practice Address - Street 2:
Practice Address - City:WOODSIDE
Practice Address - State:NY
Practice Address - Zip Code:11377-4442
Practice Address - Country:US
Practice Address - Phone:718-505-1531
Practice Address - Fax:347-808-9871
Is Sole Proprietor?:Yes
Enumeration Date:2023-08-01
Last Update Date:2023-08-01
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY117249-01104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker