Provider Demographics
NPI:1992943963
Name:SHURMAN, ELIZABETH MA (LICSW)
Entity type:Individual
Prefix:MS
First Name:ELIZABETH
Middle Name:MA
Last Name:SHURMAN
Suffix:
Gender:F
Credentials:LICSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
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Other - Credentials:
Mailing Address - Street 1:BOX 1216 ONE GUSTAVE LEVY PLACE
Mailing Address - Street 2:MOUNT SINAI VISITING DOCTOR'S PROGRAM
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10029-6574
Mailing Address - Country:US
Mailing Address - Phone:212-824-7490
Mailing Address - Fax:212-426-5108
Practice Address - Street 1:102 MAIN ST
Practice Address - Street 2:
Practice Address - City:GREENFIELD
Practice Address - State:MA
Practice Address - Zip Code:01301-3224
Practice Address - Country:US
Practice Address - Phone:413-372-9834
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2009-01-29
Last Update Date:2019-06-10
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY0769291041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical