KEVIN BANTUM
NPI 1992342331
Counselor - Addiction (Substance Use Disorder) in Brooklyn, NY

Q: What is the provider's specialty?

The provider's specialty is Counselor with taxonomy code 101YA0400X and a focus in Addiction (Substance Use Disorder).

Active since December 04, 2019

1041 BERGEN ST, BROOKLYN, NY 11216(718) 771-0760 Get Directions Write a Review

NPPES record last updated: December 4, 2019. Verified against the NPPES registry weekly; last sync: July 19, 2026.

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About Kevin Bantum NPPES

Official registry information on file with the National Plan and Provider Enumeration System.

KEVIN BANTUM (NPI 1992342331) is an individual addiction (substance use disorder) provider in Brooklyn, New York and active in the NPI registry since December 2019.

NPPES Registry Identity

NPI1992342331

Entity TypeIndividualMale

Primary Taxonomy101YA0400X

Provider Legal NameKEVIN BANTUM

Location Address1041 BERGEN STBrooklyn, NY 11216-3307

Mailing Address1041 Bergen StBrooklyn, NY 11216-3307

Phone(718) 771-0760

Sole ProprietorYes

Enumeration DateDecember 4, 2019

✔ NPI 1992342331 is a valid, active identifier and passes the ISO check-digit test.

Specialties & Licenses

★ Primary SpecialtyCounselor · Addiction (Substance Use Disorder)Behavioral Health & Social Service Providers

Taxonomy Code101YA0400X

1041 BERGEN ST, Brooklyn, NY 11216

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Other Identifiers 1

Medicaid00004567NY

Other Providers at the Same Location NPPES 13

Providers registered at the same practice address, or within the immediate area, according to the NPPES registry.

EDGARDO SANCHEZ BA, CASAC

Counselor (Addiction (Substance Use Disorder))