MS. SHELLY DAVIDOR, LCSW - NPI NUMBER 1780875203

Summary

Provider Name: MS. SHELLY DAVIDOR, LCSW

NPI Number: 1780875203

Clasification: Social Worker (104100000X)

Address:
255 15TH ST
SUITE 103, BASEMENT LEVEL
BROOKLYN, NY
ZIP 11215

Phone Number: (718) 788-5101



Detailed Information

MS. Shelly Davidor, LCSW is a social worker in Brooklyn, NY. The provider is a social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public. The assigned NPI number for this provider is 1780875203 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business address is:

255 15TH ST
SUITE 103, BASEMENT LEVEL
BROOKLYN, NY
ZIP 11215-988
Phone: (718) 788-5101

The enumeration date for this NPI number is 8/8/2007 and was last updated on 7/13/2012.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 104100000X Social Worker Yes

NPI Record

No. Field Name Field Value
1 NPI 1780875203
2 Entity Type Code 1
3 Provider Last Name Legal Name DAVIDOR
4 Provider First Name SHELLY
5 Provider Name Prefix Text MS.
6 Provider Credential Text LCSW
7 Provider First Line Business Practice Location Address 255 15TH ST
8 Provider Second Line Business Practice Location Address SUITE 103, BASEMENT LEVEL
9 Provider Business Practice Location Address City Name BROOKLYN
10 Provider Business Practice Location Address State Name NY
11 Provider Business Practice Location Address Postal Code 112154988
12 Provider Business Practice Location Address Country Code If outside U S US
13 Provider Business Practice Location Address Telephone Number 7187885101
14 Provider Enumeration Date 8/8/2007
15 Last Update Date 7/13/2012
16 Provider Gender Code F
17 Healthcare Provider Taxonomy Code 1 104100000X
18 Healthcare Provider Primary Taxonomy Switch 1 Y
19 Is Sole Proprietor N

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This page was last updated on: 7/15/2014
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