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General NPI Number Information
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NPI Number | 1144045956
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Entity Type | Individual
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Provider Name | SHAYNA CHAMISH LSW
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Gender | Female
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Dates
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Enumeration Date | 11/18/2024
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Last Update Date | 11/18/2024
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Provider Practice Location Address
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Address Line | 8-16 SUSAN PL
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City | FAIR LAWN
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State | NJ
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Zip | 07410-1616
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Country | US
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Telephone | 347-693-2798
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Fax |
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Provider Business Mailing Address
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Address Line | 522 S BROAD ST STE 8
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City | GLEN ROCK
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State | NJ
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Zip | 07452-1325
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Country | US
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Telephone |
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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 | 44SL07215900
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License Number State | NJ
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