Provider Demographics
NPI:1669127676
Name:SHEPHERD, CHELSEA SHIRAZ (LCSW)
Entity type:Individual
Prefix:MRS
First Name:CHELSEA
Middle Name:SHIRAZ
Last Name:SHEPHERD
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:MS
Other - First Name:CHELSEA
Other - Middle Name:SHIRAZ
Other - Last Name:TUSSING
Other - Suffix:
Other - Last Name Type:Former Name
Other - Credentials:
Mailing Address - Street 1:17 COHAWNEY RD
Mailing Address - Street 2:
Mailing Address - City:SCARSDALE
Mailing Address - State:NY
Mailing Address - Zip Code:10583
Mailing Address - Country:US
Mailing Address - Phone:914-263-6470
Mailing Address - Fax:
Practice Address - Street 1:220 EAST 42ND STREET YAI
Practice Address - Street 2:8TH FLOOR
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10017
Practice Address - Country:US
Practice Address - Phone:646-276-0741
Practice Address - Fax:718-283-3602
Is Sole Proprietor?:No
Enumeration Date:2022-02-17
Last Update Date:2025-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0922461041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY092246OtherLCSW LICENSE NUMBER