Provider Demographics
NPI:1578234928
Name:SHANI BEN ZVI, SHIRLEY (MA, CT, AMFT)
Entity type:Individual
Prefix:
First Name:SHIRLEY
Middle Name:
Last Name:SHANI BEN ZVI
Suffix:
Gender:F
Credentials:MA, CT, AMFT
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:150 BOXFORD CT
Mailing Address - Street 2:
Mailing Address - City:ALPHARETTA
Mailing Address - State:GA
Mailing Address - Zip Code:30022-2609
Mailing Address - Country:US
Mailing Address - Phone:770-846-2595
Mailing Address - Fax:
Practice Address - Street 1:150 BOXFORD CT
Practice Address - Street 2:
Practice Address - City:ALPHARETTA
Practice Address - State:GA
Practice Address - Zip Code:30022-2609
Practice Address - Country:US
Practice Address - Phone:770-846-2595
Practice Address - Fax:
Is Sole Proprietor?:No
Enumeration Date:2021-09-24
Last Update Date:2021-09-24
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
GAAMFT000661106H00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes106H00000XBehavioral Health & Social Service ProvidersMarriage & Family Therapist