Provider Demographics
NPI:1144808478
Name:LORQUET, SHIRLEY (CASAC-T; MHC)
Entity type:Individual
Prefix:MS
First Name:SHIRLEY
Middle Name:
Last Name:LORQUET
Suffix:
Gender:F
Credentials:CASAC-T; MHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:149-31 WELLER LA
Mailing Address - Street 2:
Mailing Address - City:ROSEDALE
Mailing Address - State:NY
Mailing Address - Zip Code:11422
Mailing Address - Country:US
Mailing Address - Phone:917-650-5837
Mailing Address - Fax:
Practice Address - Street 1:251 LAFAYETTE ST.
Practice Address - Street 2:3RD FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10012
Practice Address - Country:US
Practice Address - Phone:212-570-1693
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2021-03-30
Last Update Date:2021-03-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY1397506OtherNIOSH