Provider Demographics
NPI:1508591827
Name:SIVAN, SHIRA (LMSW)
Entity Type:Individual
Prefix:MRS
First Name:SHIRA
Middle Name:
Last Name:SIVAN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:SHIRA
Other - Middle Name:
Other - Last Name:SHAPIRO
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:LMSW
Mailing Address - Street 1:1955 MCDONALD AVE
Mailing Address - Street 2:
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11223-1805
Mailing Address - Country:US
Mailing Address - Phone:
Mailing Address - Fax:
Practice Address - Street 1:1955 MCDONALD AVE
Practice Address - Street 2:
Practice Address - City:BROOKLYN
Practice Address - State:NY
Practice Address - Zip Code:11223-1805
Practice Address - Country:US
Practice Address - Phone:718-787-1600
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-07-20
Last Update Date:2024-02-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY116893104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker