Shanna Richey

Individual provider Active NPI Social Worker · Lloyd Harbor, NY

NPI 1043694110 · NPPES record last updated Oct 24, 2016

Key facts

NPI
1043694110
Entity type
Individual (NPI type 1)
Primary specialty
Social Worker 104100000X
License
098812 (NY)
Practice address
24 Camel Hollow Rd
Lloyd Harbor, NY 11743-1604
Phone
(631) 271-5440
NPI assigned
Jul 17, 2015
Sex
Female
Sole proprietor
Yes

Medicare participation

Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
Part B services: Yes · DME: Yes · Home health: No · Power mobility devices: No · Hospice: No

Medicare enrollment records

Enrollment IDStateProvider typePAC IDDetails
I20210505002374 NY Order and Referring Only - Clinical Social Worker 8729497631

National Provider Directory

Medicare enrollment (NPD)
Yes

State licenses

LicenseStateTypeSpecialty
098812NYMDSocial Worker

Specialties & licenses

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 098812 NY Yes

Addresses

Primary practice location

24 Camel Hollow Rd
Lloyd Harbor, NY 11743-1604

Mailing address

24 Camel Hollow Rd
Lloyd Harbor, NY 11743-1604
Phone (631) 271-5440

Other providers in Lloyd Harbor, NY

All providers in Lloyd Harbor, NY · Social Worker in New York

Sources for this page

Verify at the official NPI Registry.