Provider Demographics
NPI:1851807549
Name:TWERSKY, SHOSHANA SHIRA (PSYD)
Entity type:Individual
Prefix:DR
First Name:SHOSHANA
Middle Name:SHIRA
Last Name:TWERSKY
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:2 BALA PLZ STE PL13
Mailing Address - Street 2:
Mailing Address - City:BALA CYNWYD
Mailing Address - State:PA
Mailing Address - Zip Code:19004-1506
Mailing Address - Country:US
Mailing Address - Phone:978-697-1257
Mailing Address - Fax:610-667-2608
Practice Address - Street 1:2 BALA PLZ STE PL13
Practice Address - Street 2:
Practice Address - City:BALA CYNWYD
Practice Address - State:PA
Practice Address - Zip Code:19004-1506
Practice Address - Country:US
Practice Address - Phone:215-987-2696
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2017-12-18
Last Update Date:2024-08-27
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
PAPS020172103TC0700X
PAPC006412101YP2500X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YP2500XBehavioral Health & Social Service ProvidersCounselorProfessional
Yes103TC0700XBehavioral Health & Social Service ProvidersPsychologistClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
PA005878504OtherHIGHMARK BLUE SHIELD CONTRACT ID