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General NPI Number Information
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NPI Number | 1053997437
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Entity Type | Individual
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Provider Name | SYDNEY JULIA SHEPARD LMSW
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Gender | Female
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Dates
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Enumeration Date | 03/24/2021
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Last Update Date | 03/17/2025
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Provider Practice Location Address
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Address Line | 356 W 18TH ST
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City | NEW YORK
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State | NY
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Zip | 10011-4401
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Country | US
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Telephone | 212-271-7200
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Fax |
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Provider Business Mailing Address
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Address Line | 2819 TILDEN AVE APT 2B
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City | BROOKLYN
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State | NY
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Zip | 11226-5050
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Country | US
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Telephone | 718-483-3355
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Fax |
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Authorized Official
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Title or Position |
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Name |
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Credential |
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Telephone |
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Scope of Practice (Provider's specialty)
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Taxonomy #1
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Taxonomy Code | 104100000X
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Taxonomy Name | Social Worker
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License Number | 097050
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License Number State | NY
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