Provider Demographics
NPI:1437399383
Name:BERNSTOCK, SHIRLEY (LCSW-R)
Entity Type:Individual
Prefix:MRS
First Name:SHIRLEY
Middle Name:
Last Name:BERNSTOCK
Suffix:
Gender:F
Credentials:LCSW-R
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:16 ETVILLE AVE
Mailing Address - Street 2:
Mailing Address - City:YONKERS
Mailing Address - State:NY
Mailing Address - Zip Code:10703-1145
Mailing Address - Country:US
Mailing Address - Phone:914-629-0578
Mailing Address - Fax:
Practice Address - Street 1:16 ETVILLE AVE
Practice Address - Street 2:
Practice Address - City:YONKERS
Practice Address - State:NY
Practice Address - Zip Code:10703-1145
Practice Address - Country:US
Practice Address - Phone:914-629-0578
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-04
Last Update Date:2009-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0230641041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical