Provider Demographics
NPI:1548806177
Name:GOLDSTEIN, SHIRA R (LMSW)
Entity Type:Individual
Prefix:
First Name:SHIRA
Middle Name:R
Last Name:GOLDSTEIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:SHIRA
Other - Middle Name:R
Other - Last Name:ALKHWEKHI
Other - Suffix:
Other - Last Name Type:Other Name
Other - Credentials:
Mailing Address - Street 1:10 VALLEY HEALTH PLAZA
Mailing Address - Street 2:
Mailing Address - City:PARAMUS
Mailing Address - State:NJ
Mailing Address - Zip Code:07652
Mailing Address - Country:US
Mailing Address - Phone:201-265-8200
Mailing Address - Fax:
Practice Address - Street 1:10 VALLEY HEALTH PLAZA
Practice Address - Street 2:
Practice Address - City:PARAMUS
Practice Address - State:NJ
Practice Address - Zip Code:07652
Practice Address - Country:US
Practice Address - Phone:201-265-8200
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-11-19
Last Update Date:2019-11-19
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SL065146001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical