Provider Demographics
NPI:1194217695
Name:SALOMON, SHIRLEY (LCSW)
Entity Type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:
Last Name:SALOMON
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 1:20 ROE CIR
Mailing Address - Street 2:
Mailing Address - City:MONROE
Mailing Address - State:NY
Mailing Address - Zip Code:10950-3205
Mailing Address - Country:US
Mailing Address - Phone:845-238-3372
Mailing Address - Fax:
Practice Address - Street 1:20 ROE CIR
Practice Address - Street 2:
Practice Address - City:MONROE
Practice Address - State:NY
Practice Address - Zip Code:10950-3205
Practice Address - Country:US
Practice Address - Phone:917-318-9993
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2018-05-31
Last Update Date:2021-04-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0739991041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical