Active NPI
Kenneth Louis Shanker, MHC-LP
- Mental Health Counselor
- New York, NY
National Provider Identifier
1013617778
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- P120500
- Practice address
- 1441 Broadway
5TH Floor
New York, NY 10018 - Phone
- (646) 410-1151
- NPI assigned
- Mar 9, 2023
- Sex
- Male
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | P120500 | NY | Primary |
Addresses
Primary practice location
1441 Broadway
5TH Floor
New York, NY 10018
Mailing address
603 W 148TH St Apt 2C
New York, NY 10031-3134
Phone (917) 592-8446
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| P120500 | NY | MD | Mental Health Counselor |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1678320000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1678320000000",
"number": "1013617778",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "603 W 148TH ST APT 2C",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100313134",
"telephone_number": "917-592-8446"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1441 BROADWAY",
"address_2": "5TH FLOOR",
"city": "NEW YORK",
"state": "NY",
"postal_code": "10018",
"telephone_number": "646-410-1151"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHANKER",
"first_name": "KENNETH",
"middle_name": "LOUIS",
"credential": "MHC-LP",
"sole_proprietor": "YES",
"sex": "M",
"enumeration_date": "2023-03-09",
"last_updated": "2023-03-09",
"certification_date": "2023-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "P120500",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}
Other providers in New York, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 9, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.