Provider Demographics
NPI:1982845749
Name:MASHACK, SHEILA RENEE (LMHC)
Entity Type:Individual
Prefix:MISS
First Name:SHEILA
Middle Name:RENEE
Last Name:MASHACK
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3336 BRONXWOOD AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10469-3608
Mailing Address - Country:US
Mailing Address - Phone:646-369-5100
Mailing Address - Fax:
Practice Address - Street 1:3336 BRONXWOOD AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10469-3608
Practice Address - Country:US
Practice Address - Phone:646-369-5100
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-03-09
Last Update Date:2009-03-09
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY001396-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health