Provider Demographics
NPI:1770723538
Name:BAYER, SHAWN V (LMSW)
Entity type:Individual
Prefix:MR
First Name:SHAWN
Middle Name:V
Last Name:BAYER
Suffix:
Gender:M
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:4500 FURMAN AVE
Mailing Address - Street 2:
Mailing Address - City:BRONX
Mailing Address - State:NY
Mailing Address - Zip Code:10470-1602
Mailing Address - Country:US
Mailing Address - Phone:917-696-9490
Mailing Address - Fax:718-324-6845
Practice Address - Street 1:4500 FURMAN AVE
Practice Address - Street 2:
Practice Address - City:BRONX
Practice Address - State:NY
Practice Address - Zip Code:10470-1602
Practice Address - Country:US
Practice Address - Phone:917-696-9490
Practice Address - Fax:718-324-6845
Is Sole Proprietor?:No
Enumeration Date:2009-03-05
Last Update Date:2009-03-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027476101YM0800X, 104100000X, 1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker
No101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical