Provider Demographics
NPI:1588084230
Name:NJELEKA, TASHARIKA
Entity type:Individual
Prefix:
First Name:TASHARIKA
Middle Name:
Last Name:NJELEKA
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:TASHARIKA
Other - Middle Name:
Other - Last Name:WHITFIELD
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:2755 W INTERSTATE 20 APT A243
Mailing Address - Street 2:
Mailing Address - City:GRAND PRAIRIE
Mailing Address - State:TX
Mailing Address - Zip Code:75052-7172
Mailing Address - Country:US
Mailing Address - Phone:469-261-8227
Mailing Address - Fax:
Practice Address - Street 1:1881 SYLVAN AVE STE 200
Practice Address - Street 2:
Practice Address - City:DALLAS
Practice Address - State:TX
Practice Address - Zip Code:75208-2031
Practice Address - Country:US
Practice Address - Phone:214-743-1200
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-04-21
Last Update Date:2023-11-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
OK6417101YP2500X
TX82911101YM0800X, 101YP2500X, 101Y00000X
171M00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101Y00000XBehavioral Health & Social Service ProvidersCounselor
No101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No171M00000XOther Service ProvidersCase Manager/Care Coordinator