Provider Demographics
NPI:1497092415
Name:SHICHMAN, HELEN
Entity Type:Individual
Prefix:MRS
First Name:HELEN
Middle Name:
Last Name:SHICHMAN
Suffix:
Gender:F
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:109 HIGH FARMS RD
Mailing Address - Street 2:
Mailing Address - City:GLEN HEAD
Mailing Address - State:NY
Mailing Address - Zip Code:11545-2226
Mailing Address - Country:US
Mailing Address - Phone:516-671-6117
Mailing Address - Fax:516-671-6384
Practice Address - Street 1:109 HIGH FARMS RD
Practice Address - Street 2:
Practice Address - City:GLEN HEAD
Practice Address - State:NY
Practice Address - Zip Code:11545-2226
Practice Address - Country:US
Practice Address - Phone:516-671-6117
Practice Address - Fax:516-671-6384
Is Sole Proprietor?:Yes
Enumeration Date:2013-01-10
Last Update Date:2013-01-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY484957103K00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103K00000XBehavioral Health & Social Service ProvidersBehavior Analyst