Provider Demographics
NPI:1285874420
Name:PEYSER, SHOSHANA (LCSW-R, PHD)
Entity type:Individual
Prefix:DR
First Name:SHOSHANA
Middle Name:
Last Name:PEYSER
Suffix:
Gender:F
Credentials:LCSW-R, PHD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:1241 MAMARONECK AVE.
Mailing Address - Street 2:
Mailing Address - City:WHITE PLAINS
Mailing Address - State:NY
Mailing Address - Zip Code:10605
Mailing Address - Country:US
Mailing Address - Phone:917-686-9380
Mailing Address - Fax:
Practice Address - Street 1:1241 MAMARONECK AVE
Practice Address - Street 2:
Practice Address - City:WHITE PLAINS
Practice Address - State:NY
Practice Address - Zip Code:10605-5201
Practice Address - Country:US
Practice Address - Phone:917-686-9380
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2009-02-28
Last Update Date:2013-01-03
Deactivation Date:2012-08-14
Deactivation Code:
Reactivation Date:2012-12-28
Provider Licenses
StateLicense IDTaxonomies
NYR037821-1104100000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes104100000XBehavioral Health & Social Service ProvidersSocial Worker