Provider Demographics
NPI:1588396287
Name:SHECTER, ADAM JAMES
Entity type:Individual
Prefix:
First Name:ADAM
Middle Name:JAMES
Last Name:SHECTER
Suffix:
Gender:M
Credentials:
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:3988 52ND ST APT 3
Mailing Address - Street 2:
Mailing Address - City:WOODSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11377-3229
Mailing Address - Country:US
Mailing Address - Phone:917-301-9841
Mailing Address - Fax:
Practice Address - Street 1:517 W 29TH ST
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10001-1317
Practice Address - Country:US
Practice Address - Phone:862-245-2498
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2022-06-30
Last Update Date:2022-06-30
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY1166131041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical