Provider Demographics
NPI:1972371102
Name:ALSTON, LATEEFAH
Entity type:Individual
Prefix:MS
First Name:LATEEFAH
Middle Name:
Last Name:ALSTON
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:LATEEFAH
Other - Middle Name:
Other - Last Name:KAMARA
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:LMHC
Mailing Address - Street 1:PO BOX 391
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10710-0391
Mailing Address - Country:US
Mailing Address - Phone:718-614-1863
Mailing Address - Fax:
Practice Address - Street 1:92 MINERVA DR
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10710-3021
Practice Address - Country:US
Practice Address - Phone:718-614-1863
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2023-12-18
Last Update Date:2024-07-18
Deactivation Date:2024-03-28
Deactivation Code:
Reactivation Date:2024-07-18
Provider Licenses
StateLicense IDTaxonomies
NY013813101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health