Provider Demographics
NPI:1407999386
Name:ZEMON, STEPHANIE MONA (LCSW)
Entity Type:Individual
Prefix:MS
First Name:STEPHANIE
Middle Name:MONA
Last Name:ZEMON
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:STEPHANIE
Other - Middle Name:ZEMON
Other - Last Name:SCHNEIDER
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:133 WILLOW ST
Mailing Address - Street 2:
Mailing Address - City:ROSLYN HEIGHTS
Mailing Address - State:NY
Mailing Address - Zip Code:11577-1215
Mailing Address - Country:US
Mailing Address - Phone:516-625-9316
Mailing Address - Fax:
Practice Address - Street 1:125 MINEOLA AVE
Practice Address - Street 2:105
Practice Address - City:ROSLYN HEIGHTS
Practice Address - State:NY
Practice Address - Zip Code:11577-2023
Practice Address - Country:US
Practice Address - Phone:516-625-3927
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2007-02-14
Last Update Date:2007-07-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYPR0188371041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN07172Medicare PIN