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General NPI Number Information
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NPI Number | 1235725771
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Entity Type | Individual
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Provider Name | SHOSHANA SILVERMAN BELISLE LMSW
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Gender | Female
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Dates
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Enumeration Date | 12/18/2020
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Last Update Date | 12/18/2020
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Provider Practice Location Address
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Address Line | 200 PROSPECT PARK W
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City | BROOKLYN
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State | NY
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Zip | 11215-5747
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Country | US
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Telephone | 212-621-7770
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Fax |
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Provider Business Mailing Address
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Address Line | 632 COLLEGE HILL RD
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City | WOODSTOCK
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State | VT
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Zip | 05091-3006
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Country | US
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Telephone | 917-494-9663
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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 | 067858
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License Number State | NY
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