Provider Demographics
NPI:1518789148
Name:SANCHEZ, SHIRLEY ELVIRA (MS, LAC, NCC)
Entity type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:ELVIRA
Last Name:SANCHEZ
Suffix:
Gender:F
Credentials:MS, LAC, NCC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1215 HIGHWAY 70 STE 2002
Mailing Address - Street 2:
Mailing Address - City:LAKEWOOD
Mailing Address - State:NJ
Mailing Address - Zip Code:08701-7041
Mailing Address - Country:US
Mailing Address - Phone:732-902-0575
Mailing Address - Fax:
Practice Address - Street 1:1215 HIGHWAY 70 STE 2002
Practice Address - Street 2:
Practice Address - City:LAKEWOOD
Practice Address - State:NJ
Practice Address - Zip Code:08701-7041
Practice Address - Country:US
Practice Address - Phone:732-902-0575
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-10-25
Last Update Date:2024-10-25
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NJ37AC00814900101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health