| Doctor Name: | MS. SHAHLA GOROVOY |
| NPI Number: | 1003143934 |
| Entity Type Code: | Individual (1) |
| Gender: | F |
| Credentials: | LCSW |
| License Number: | 076905 |
| Business Practice Address: | 41 Dolson Ave Suite 9 (c/o Dr. Al-tariq) Middletown, NY - 109406489 |
| Business Phone Number: | 8453256202 |
| Business Fax Number: | |
| Mailing Address: | P.o.box 439, HARRIMAN |
| State: | NY |
| Postal Code: | 109260439 |
| Phone Number: | 8453256202 |
| Fax Number: | |
| NPI Enumeration Date: | 11/13/2009 |
| NPI Last Update Date: | 08/25/2010 |
| Replacement NPI: | 0 |
| NPI Deactivation Date: | |
| NPI Reactivation Date: |
Taxonomy Information: | |
| Healthcare Provider Taxonomy: | 1041C0700X |
| License Number: | 076905 |
| Healthcare Provider Taxonomy: (Secondary) | Y |
| State: | NY |
| Taxonomy Type: | Behavioral Health & Social Service Providers |
| Taxonomy Classification: | Social Worker |
| Taxonomy Specialization: | Clinical |
| Taxonomy Definition: | A social worker who holds a master |