Healthcare Provider Details

I. General information

NPI: 1821759184
Provider Name (Legal Business Name): SHIRLY ASLAN JOORY LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/07/2022
Last Update Date: 09/18/2026
Certification Date: 09/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

857 S OYSTER BAY RD
BETHPAGE NY
11714-1030
US

IV. Provider business mailing address

857 S OYSTER BAY RD
BETHPAGE NY
11714-1030
US

V. Phone/Fax

Practice location:
  • Phone: 516-622-8888
  • Fax:
Mailing address:
  • Phone: 516-622-8888
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number114661
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: