Provider Demographics
NPI:1316954753
Name:SHORIN, ALENE S (LCSW)
Entity type:Individual
Prefix:MS
First Name:ALENE
Middle Name:S
Last Name:SHORIN
Suffix:
Gender:F
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:PO BOX 1037
Mailing Address - Street 2:
Mailing Address - City:SYOSSET
Mailing Address - State:NY
Mailing Address - Zip Code:11791-0080
Mailing Address - Country:US
Mailing Address - Phone:516-521-9625
Mailing Address - Fax:516-364-1318
Practice Address - Street 1:30 WYNN CT
Practice Address - Street 2:
Practice Address - City:SYOSSET
Practice Address - State:NY
Practice Address - Zip Code:11791-2426
Practice Address - Country:US
Practice Address - Phone:516-521-9625
Practice Address - Fax:516-364-1318
Is Sole Proprietor?:Yes
Enumeration Date:2006-08-01
Last Update Date:2010-05-05
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR032382-1 NY1041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
NYN79232Medicare ID - Type UnspecifiedPRIVATE PRACTICE
NYN79231Medicare ID - Type UnspecifiedPEDERSON-KRAG CENTER