Provider Demographics
NPI:1669525671
Name:SHOR, ELAINE (LPC, ATR-BC)
Entity type:Individual
Prefix:
First Name:ELAINE
Middle Name:
Last Name:SHOR
Suffix:
Gender:F
Credentials:LPC, ATR-BC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:24 MERCHANTS WAY STE 104
Mailing Address - Street 2:
Mailing Address - City:COLTS NECK
Mailing Address - State:NJ
Mailing Address - Zip Code:07722-1570
Mailing Address - Country:US
Mailing Address - Phone:732-761-1500
Mailing Address - Fax:732-845-9499
Practice Address - Street 1:24 MERCHANTS WAY STE 104
Practice Address - Street 2:
Practice Address - City:COLTS NECK
Practice Address - State:NJ
Practice Address - Zip Code:07722-1570
Practice Address - Country:US
Practice Address - Phone:732-761-1500
Practice Address - Fax:732-845-9499
Is Sole Proprietor?:Yes
Enumeration Date:2007-01-21
Last Update Date:2007-09-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
221700000X
NJ37PC00363800101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
No221700000XRespiratory, Developmental, Rehabilitative and Restorative Service ProvidersArt Therapist