Provider Demographics
NPI:1881041770
Name:HON-LAHAV, SHIRA (MA, LCAT,RDT)
Entity Type:Individual
Prefix:
First Name:SHIRA
Middle Name:
Last Name:HON-LAHAV
Suffix:
Gender:F
Credentials:MA, LCAT,RDT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:201 E 36TH ST
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10016-3668
Mailing Address - Country:US
Mailing Address - Phone:646-379-2622
Mailing Address - Fax:
Practice Address - Street 1:240 MADISON AVE
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10016-2820
Practice Address - Country:US
Practice Address - Phone:646-379-2622
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2016-05-20
Last Update Date:2016-05-20
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
101YA0400X, 101YM0800X, 102L00000X, 103TH0100X
NY05-001675103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist
No101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No102L00000XBehavioral Health & Social Service ProvidersPsychoanalyst
No103TH0100XBehavioral Health & Social Service ProvidersPsychologistHealth Service