Provider Demographics
NPI:1679610893
Name:SHAKHMUROV COUNSELING INC
Entity type:Organization
Organization Name:SHAKHMUROV COUNSELING INC
Other - Org Name:
Other - Org Type:
Authorized Official - Title/Position:CLINICAL SOCIAL WORKER
Authorized Official - Prefix:MS
Authorized Official - First Name:MARGARITA
Authorized Official - Middle Name:
Authorized Official - Last Name:SHAKHMUROV
Authorized Official - Suffix:
Authorized Official - Credentials:LCSW
Authorized Official - Phone:917-846-2538
Mailing Address - Street 1:873 CHERRY LN
Mailing Address - Street 2:
Mailing Address - City:VALLEY STREAM
Mailing Address - State:NY
Mailing Address - Zip Code:11581-2722
Mailing Address - Country:US
Mailing Address - Phone:917-846-2538
Mailing Address - Fax:516-295-2808
Practice Address - Street 1:9830 67TH AVE
Practice Address - Street 2:SUITE CC
Practice Address - City:REGO PARK
Practice Address - State:NY
Practice Address - Zip Code:11374-4966
Practice Address - Country:US
Practice Address - Phone:917-846-2538
Practice Address - Fax:516-295-2808
EIN:<UNAVAIL>
Is Organization Subpart?:No
Parent Organization LBN:
Parent Organization TIN:
Enumeration Date:2007-01-30
Last Update Date:2012-08-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR055855-11041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinicalGroup - Single Specialty