Provider Demographics
NPI:1598148256
Name:SHAYNA GOLDSTEIN, LMFT, LLC
Entity Type:Organization
Organization Name:SHAYNA GOLDSTEIN, LMFT, LLC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:MARRIAGER AND FAMILY THERAPIST
Authorized Official - Prefix:MS
Authorized Official - First Name:SHAYNA
Authorized Official - Middle Name:
Authorized Official - Last Name:GOLDSTEIN
Authorized Official - Suffix:
Authorized Official - Credentials:LMFT
Authorized Official - Phone:773-590-2670
Mailing Address - Street 1:1770 W BERTEAU AVE
Mailing Address - Street 2:#302A
Mailing Address - City:CHICAGO
Mailing Address - State:IL
Mailing Address - Zip Code:60613-1849
Mailing Address - Country:US
Mailing Address - Phone:773-590-2670
Mailing Address - Fax:
Practice Address - Street 1:1770 W BERTEAU AVE
Practice Address - Street 2:#302A
Practice Address - City:CHICAGO
Practice Address - State:IL
Practice Address - Zip Code:60613-1849
Practice Address - Country:US
Practice Address - Phone:773-590-2670
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2015-06-30
Last Update Date:2015-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family TherapistGroup - Single Specialty