MEDICARE: SHIRA KNOPF-GHOLIAN

Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

#	Taxonomy Code	Taxonomy	License Number	License Number State
1	101YM0800X	Mental Health Counselor

General Provider Information

NPI Number	:	1376890681
Entity Type Code	:	Individual
Provider Name (Legal Business Name)	:	SHIRA KNOPF-GHOLIAN

Provider Business Mailing Address
First Line	:	1540 E 38TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-3420
Country	:	US
Telephone Number	:	917-202-9644
Fax Number	:

Provider Business Practice Location Address
First Line	:	1540 E 38TH ST
Second Line	:
City	:	BROOKLYN
State	:	NY
Zip	:	11234-3420
Country	:	US
Telephone Number	:	347-746-4524
Fax Number	:	718-859-7157

Authorized Official
Title or Position	:
Name	:
Credential	:
Telephone Number	:

Provider Enumeration Date	:	08/07/2012
Last Update Date	:	01/14/2025

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Directions to “ SHIRA KNOPF-GHOLIAN ” Practice Location

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