Provider Demographics
NPI:1164770681
Name:GELBFISH-FREUND, SHAYNE T (LCSW)
Entity Type:Individual
Prefix:MRS
First Name:SHAYNE
Middle Name:T
Last Name:GELBFISH-FREUND
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 1:15 14TH ST
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-1916
Mailing Address - Country:US
Mailing Address - Phone:732-367-9206
Mailing Address - Fax:
Practice Address - Street 1:15 14TH ST
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-1916
Practice Address - Country:US
Practice Address - Phone:732-367-9206
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2012-08-15
Last Update Date:2012-08-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY44SC053933001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical