Provider Demographics
NPI:1114082492
Name:HOLTZMAN, SHIRLEY L (LCSW)
Entity Type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:L
Last Name:HOLTZMAN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:LEE
Other - Middle Name:
Other - Last Name:HOLTZMAN
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:38 S OYSTER BAY RD
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-5033
Mailing Address - Country:US
Mailing Address - Phone:516-383-7380
Mailing Address - Fax:
Practice Address - Street 1:38 S OYSTER BAY RD
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-5033
Practice Address - Country:US
Practice Address - Phone:516-383-7380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2006-12-27
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR021029-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical