Organization Name: | STILLWATER THERAPY LCSW P.C. |
NPI Number: | 1053550624 |
Entity Type Code: | Organizational (2) |
Authorized Official Name: | SHAFER ZYSMAN (PRESIDENT) |
Mailing Address: | 1840 Union Blvd Bay Shore |
State: | NY US |
Postal Code: | 117067932 |
Phone Number: | 6316477885 |
Fax Number: | 6316477893 |
NPI Enumeration Date: | 02/05/2009 |
NPI Last Update Date: | 02/05/2009 |
Replacement NPI: | 0 |
NPI Deactivation Date: | |
NPI Reactivation Date: |
Taxonomy Information: | |
Healthcare Provider Taxonomy: | 1041C0700X |
License Number: | RP25669-1 |
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 |