Provider Demographics
NPI:1386488666
Name:BLECHERMAN, SHAYNA P
Entity type:Individual
Prefix:
First Name:SHAYNA
Middle Name:P
Last Name:BLECHERMAN
Suffix:
Gender:X
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2233 HUNTINGTON TPKE
Mailing Address - Street 2:
Mailing Address - City:TRUMBULL
Mailing Address - State:CT
Mailing Address - Zip Code:06611-5059
Mailing Address - Country:US
Mailing Address - Phone:973-865-5818
Mailing Address - Fax:
Practice Address - Street 1:2233 HUNTINGTON TPKE
Practice Address - Street 2:
Practice Address - City:TRUMBULL
Practice Address - State:CT
Practice Address - Zip Code:06611-5059
Practice Address - Country:US
Practice Address - Phone:973-865-5818
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2024-06-21
Last Update Date:2024-06-21
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
No101Y00000XBehavioral Health & Social Service ProvidersCounselor