Provider Demographics
NPI:1114547593
Name:SHATZKY, JUDITH (LCSW)
Entity Type:Individual
Prefix:MS
First Name:JUDITH
Middle Name:
Last Name:SHATZKY
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 1:421 AVENUE C APT 3D
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11218-4576
Mailing Address - Country:US
Mailing Address - Phone:646-404-1508
Mailing Address - Fax:
Practice Address - Street 1:36 W 25TH ST FL 10
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10010-2753
Practice Address - Country:US
Practice Address - Phone:212-689-7740
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-04-25
Last Update Date:2020-04-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0861361041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical