Provider Demographics
NPI:1609163146
Name:ROBIN S SHIMEL LCSW PSYCHOTHERAPY SERVICES, LLC
Entity Type:Organization
Organization Name:ROBIN S SHIMEL LCSW PSYCHOTHERAPY SERVICES, LLC
Other - Org Name:ROBIN S.SHIMEL, LCSW
Other - Org Type:Other Name
Authorized Official - Title/Position:OWNER
Authorized Official - Prefix:
Authorized Official - First Name:ROBIN
Authorized Official - Middle Name:S
Authorized Official - Last Name:SHIMEL
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:973-379-1350
Mailing Address - Street 1:5 N COBANE TER
Mailing Address - Street 2:
Mailing Address - City:WEST ORANGE
Mailing Address - State:NJ
Mailing Address - Zip Code:07052-4011
Mailing Address - Country:US
Mailing Address - Phone:973-669-2963
Mailing Address - Fax:
Practice Address - Street 1:26 LINDEN AVE
Practice Address - Street 2:SUITE 103
Practice Address - City:SPRINGFIELD
Practice Address - State:NJ
Practice Address - Zip Code:07081-1834
Practice Address - Country:US
Practice Address - Phone:973-379-1350
Practice Address - Fax:
EIN:<UNAVAIL>
Is Organization Subpart?:Yes
Parent Organization LBN:0400413195
Parent Organization TIN:<UNAVAIL>
Enumeration Date:2011-07-05
Last Update Date:2011-07-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ44SC004310001041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty