Provider Demographics
NPI:1073667812
Name:YERUSHALMI, SHLOMIT M (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHLOMIT
Middle Name:M
Last Name:YERUSHALMI
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:121 NEWARK AVE STE 535
Mailing Address - Street 2:
Mailing Address - City:JERSEY CITY
Mailing Address - State:NJ
Mailing Address - Zip Code:07302-5873
Mailing Address - Country:US
Mailing Address - Phone:201-677-2232
Mailing Address - Fax:
Practice Address - Street 1:121 NEWARK AVE STE 535
Practice Address - Street 2:
Practice Address - City:JERSEY CITY
Practice Address - State:NJ
Practice Address - Zip Code:07302-5873
Practice Address - Country:US
Practice Address - Phone:201-677-2232
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-22
Last Update Date:2020-02-17
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SCO45114001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical