Healthcare Provider Details

I. General information

NPI: 1972242923
Provider Name (Legal Business Name): SHOSHANNA ALEXANDER-HERON LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

Provider Other Name: SHOSHANNA ALEXANDER LCSW

II. Dates (important events)

Enumeration Date: 05/28/2022
Last Update Date: 10/05/2026
Certification Date: 10/05/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

73 MARKET ST STE 376
YONKERS NY
10710-7619
US

IV. Provider business mailing address

18 LAFAYETTE AVE
MASTIC NY
11950-2806
US

V. Phone/Fax

Practice location:
  • Phone: 347-742-5511
  • Fax: 914-574-2017
Mailing address:
  • Phone: 631-833-4038
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code101Y00000X
TaxonomyCounselor
License Number
License Number StateNULL

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: