Provider Demographics
NPI:1225787047
Name:FOLTS, SHAUNA (LMSW)
Entity Type:Individual
Prefix:MISS
First Name:SHAUNA
Middle Name:
Last Name:FOLTS
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:491 MANHATTAN AVE APT 3R
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10027-5231
Mailing Address - Country:US
Mailing Address - Phone:480-227-2966
Mailing Address - Fax:
Practice Address - Street 1:491 MANHATTAN AVE APT 3R
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10027-5231
Practice Address - Country:US
Practice Address - Phone:480-227-2966
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-03-20
Last Update Date:2022-03-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY115543-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical