Provider Demographics
NPI:1720626674
Name:KAUFMANN, SHELBY (LCSW)
Entity type:Individual
Prefix:
First Name:SHELBY
Middle Name:
Last Name:KAUFMANN
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 1:140 BEEKMAN ST # 1
Mailing Address - Street 2:
Mailing Address - City:SARATOGA SPRINGS
Mailing Address - State:NY
Mailing Address - Zip Code:12866-3025
Mailing Address - Country:US
Mailing Address - Phone:847-420-5258
Mailing Address - Fax:
Practice Address - Street 1:25 WILLOWBROOK RD
Practice Address - Street 2:
Practice Address - City:QUEENSBURY
Practice Address - State:NY
Practice Address - Zip Code:12804-5882
Practice Address - Country:US
Practice Address - Phone:518-926-7100
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2019-12-11
Last Update Date:2023-12-15
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0953581041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical