Provider Demographics
NPI:1053787879
Name:SHESTACK, LONDY (MA)
Entity type:Individual
Prefix:
First Name:LONDY
Middle Name:
Last Name:SHESTACK
Suffix:
Gender:F
Credentials:MA
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:595 BETHLEHEM PIKE STE 106
Mailing Address - Street 2:
Mailing Address - City:MONTGOMERYVILLE
Mailing Address - State:PA
Mailing Address - Zip Code:18936-9710
Mailing Address - Country:US
Mailing Address - Phone:215-997-2000
Mailing Address - Fax:215-997-2282
Practice Address - Street 1:595 BETHLEHEM PIKE STE 106
Practice Address - Street 2:
Practice Address - City:MONTGOMERYVILLE
Practice Address - State:PA
Practice Address - Zip Code:18936-9710
Practice Address - Country:US
Practice Address - Phone:215-997-2000
Practice Address - Fax:215-997-2282
Is Sole Proprietor?:No
Enumeration Date:2015-08-16
Last Update Date:2015-08-16
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health