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NPI Code Detail

MEDICARE: SHIRA SPEISER LCSW

MEDICARE: SHIRA SPEISER LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker929-122WI
21041C0700XClinical Social Worker44SC05357500NJ

General Provider Information

NPI Number : 1538267968
Entity Type Code : Individual
Provider Name (Legal Business Name) : SHIRA SPEISER LCSW
Provider Business Mailing Address
First Line : 1771 MADISON AVE
Second Line :
City : LAKEWOOD
State : NJ
Zip : 08701-1251
Country : US
Telephone Number : 732-364-2144
Fax Number : 732-364-3559
Provider Business Practice Location Address
First Line : 1771 MADISON AVE
Second Line :
City : LAKEWOOD
State : NJ
Zip : 08701-1251
Country : US
Telephone Number : 732-364-2144
Fax Number : 732-364-3559
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 09/20/2006
Last Update Date : 12/05/2008

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Directions to “ SHIRA SPEISER LCSW” Practice Location

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