Provider Demographics
NPI:1043948599
Name:SHAKOOR, IBN SHARIF (LPC)
Entity Type:Individual
Prefix:MR
First Name:IBN
Middle Name:SHARIF
Last Name:SHAKOOR
Suffix:
Gender:M
Credentials:LPC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:10 MAIN ST APT 726
Mailing Address - Street 2:
Mailing Address - City:WOODBRIDGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07095-3389
Mailing Address - Country:US
Mailing Address - Phone:201-918-0531
Mailing Address - Fax:
Practice Address - Street 1:638 NEWARK AVE
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07306-2306
Practice Address - Country:US
Practice Address - Phone:201-216-0197
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2022-08-11
Last Update Date:2023-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37PC00974800101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional