Provider Demographics
NPI:1568860328
Name:SHEIN, MONALYNN (LMSW)
Entity Type:Individual
Prefix:
First Name:MONALYNN
Middle Name:
Last Name:SHEIN
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:5 BROWNS RIVER RD
Mailing Address - Street 2:
Mailing Address - City:BAYPORT
Mailing Address - State:NY
Mailing Address - Zip Code:11705
Mailing Address - Country:US
Mailing Address - Phone:631-834-3093
Mailing Address - Fax:631-472-6502
Practice Address - Street 1:5 BROWNS RIVER ROAD
Practice Address - Street 2:BAYPORT
Practice Address - City:BAYPORT
Practice Address - State:NY
Practice Address - Zip Code:11705
Practice Address - Country:US
Practice Address - Phone:631-472-6502
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2014-12-10
Last Update Date:2014-12-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY082783101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health