Shantia Nicole Geralds, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

087672 Issued in NY

Practice address

70 E Sunrise Hwy Ste 500
Valley Stream, NY 11581-1233

Phone

(516) 884-9977

Fax

(718) 478-3456

NPI assigned

May 23, 2012

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Enrolled in NY, NJ2 enrollments

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 2

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Open-Minded Therapy, LCSW, PLLC

  • Clinical Social Worker
  • Valley Stream, NY
  • NPI 1730850728

  NJ

  Medicare reassignment NPD Authorized official
• Coordinated Behavioral Care Ipa Inc

  • Multi-Specialty Clinic/Center
  • Bronx, NY
  • NPI 1457881443
  NPD (past)
• New York Psychotherapy and Counseling Center

  • Community/Behavioral Health Agency
  • Jamaica, NY
  • NPI 1902811342
  NPD (past)

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

{
    "created_epoch": "1337731200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1628121600000",
    "number": "1093075087",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "70 E SUNRISE HWY STE 500",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115811233",
            "telephone_number": "516-884-9977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "70 E SUNRISE HWY STE 500",
            "city": "VALLEY STREAM",
            "state": "NY",
            "postal_code": "115811233",
            "telephone_number": "516-884-9977",
            "fax_number": "718-478-3456"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "GERALDS",
        "first_name": "SHANTIA",
        "middle_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-05-23",
        "last_updated": "2021-08-05",
        "certification_date": "2021-08-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "085254",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "087672",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Salma Gene, PA
• Genovese Drug Stores Inc
• Abdele F George, DMIN
• Cassandra Gerace
• Gerald Weir, Lac
• Marie Germain
• Germaine Cares Inc
• Princess Vilbrun Gervais-Labady
• Brittany Gervasi, PHARMD
• Eugenia E. Ghartey, MSED

• Clinical Social Worker in Valley Stream, NY
• Providers in Valley Stream, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 5, 2021; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.