1669127676 NPI number — MRS. CHELSEA SHIRAZ SHEPHERD LCSW

Table of content: MRS. CHELSEA SHIRAZ SHEPHERD LCSW (NPI 1669127676)

General

This information contains only most important part of the NPI data, for complete information, including NPI referencing materials please refer to 1669127676 NPI number — MRS. CHELSEA SHIRAZ SHEPHERD LCSW

Organization/Personal Information

Employer Identification Number (EIN):
Provider Organization Name:
Provider Last Name:
SHEPHERD
Provider First Name:
CHELSEA
Provider Middle Name:
SHIRAZ
Provider Name Prefix Text:
MRS.
Provider Name Suffix Text:
Provider Credential Text:
LCSW
Provider Gender Code:
F

Provider's Other Name Information

Provider Other Organization Name:
Provider Other Organization Name Type Code:
Provider Other Last Name:
TUSSING
Provider Other First Name:
CHELSEA
Provider Other Middle Name:
SHIRAZ
Provider Other Name Prefix Text:
MS.
Provider Other Name Suffix Text:
Provider Other Credential Text:
Provider Other Last Name Type Code:
1

NPI Number Information

NPI Number:
1669127676
Entity Type Code:
Individual
Replacement NPI:
Last Update Date:
08/27/2025
NPI Deactivation Reason Code:
NPI Deactivation Date:
NPI Reactivation Date:

Provider's Business Mailing Address

Provider First Line Business Mailing Address:
17 COHAWNEY RD
Provider Second Line Business Mailing Address:
Provider Business Mailing Address City Name:
SCARSDALE
Provider Business Mailing Address State Name:
NY
Provider Business Mailing Address Postal Code:
10583
Provider Business Mailing Address Country Code:
US
Provider Business Mailing Address Telephone Number:
914-263-6470
Provider Business Mailing Address Fax Number:

Provider's Practice Location Mailing Address

Provider First Line Business Practice Location Address:
220 EAST 42ND STREET YAI
Provider Second Line Business Practice Location Address:
8TH FLOOR
Provider Business Practice Location Address City Name:
NEW YORK
Provider Business Practice Location Address State Name:
NY
Provider Business Practice Location Address Postal Code:
10017
Provider Business Practice Location Address Country Code:
US
Provider Business Practice Location Address Telephone Number:
646-276-0741
Provider Business Practice Location Address Fax Number:
718-283-3602
Provider Enumeration Date:
02/17/2022

Additional Information

Authorized Official

Authorized Official Last Name:
Authorized Official First Name:
Authorized Official Middle Name:
Authorized Official Title or Position:
Authorized Official Telephone Number:

Provider Taxonomy Codes

  • Taxonomy code: 1041C0700X , with the licence number:  092246 , registered in the state of NY ; information, associated with the NPI states the following Primary Taxonomy Switch: "Y" .

Other Provider's Identifiers (legacy, non-NPI)

  • Identifier: 092246 . This is a "LCSW LICENSE NUMBER" identifier , issued by the state of ( NY ) . This identifiers is of the category "OTHER".




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