Individual provider Active NPI

Yael Shayne, LCSW-R

  • Clinical Social Worker
  • Great Neck, NY
National Provider Identifier
1023477767
Registry record updated Feb 22, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R076300-1 Issued in NY
Practice address
45 N Station PLZ
Suite 305
Great Neck, NY 11021-5033
Phone
(516) 382-1145
NPI assigned
Feb 22, 2016
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Feb 22, 2016

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X R076300-1 NY Primary

Addresses

Primary practice location

45 N Station PLZ
Suite 305
Great Neck, NY 11021-5033

Mailing address

22 Allenwood Rd
Great Neck, NY 11023-2127
Phone (516) 382-1145

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

LicenseStateTypeSpecialty
R076300-1NYMDClinical Social Worker

NPI Registry JSON

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1456099200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1456099200000",
    "number": "1023477767",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "22 ALLENWOOD RD",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110232127",
            "telephone_number": "516-382-1145"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "45 N STATION PLZ",
            "address_2": "SUITE 305",
            "city": "GREAT NECK",
            "state": "NY",
            "postal_code": "110215033",
            "telephone_number": "516-382-1145"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAYNE",
        "first_name": "YAEL",
        "credential": "LCSW-R",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2016-02-22",
        "last_updated": "2016-02-22",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R076300-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Great Neck, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 22, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.