Provider Demographics
NPI:1053554774
Name:SHAHNA, MONNA (LMSW)
Entity type:Individual
Prefix:
First Name:MONNA
Middle Name:
Last Name:SHAHNA
Suffix:
Gender:F
Credentials:LMSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:412 9TH ST
Mailing Address - Street 2:APT. 4
Mailing Address - City:BROOKLYN
Mailing Address - State:NY
Mailing Address - Zip Code:11215-4158
Mailing Address - Country:US
Mailing Address - Phone:703-975-2277
Mailing Address - Fax:
Practice Address - Street 1:21111 NORTHERN BLVD
Practice Address - Street 2:2ND FLOOR
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11361-3241
Practice Address - Country:US
Practice Address - Phone:718-705-1000
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-04-10
Last Update Date:2009-04-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY078860104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker