Individual provider Active NPI

Niurka Canelo Shkolnik, LCSW

  • Clinical Social Worker
  • Boca Raton, FL
National Provider Identifier
1104220060
Registry record updated Jan 2, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
SW13266 Issued in FL
Practice address
7000 W Palmetto Park Rd Ste 210
Boca Raton, FL 33433-3430
Phone
(561) 444-7222
NPI assigned
Oct 21, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jan 2, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 18912 MD
Clinical Social Worker 1041C0700X SW13266 FL Primary

Addresses

Primary practice location

7000 W Palmetto Park Rd Ste 210
Boca Raton, FL 33433-3430

Mailing address

9497 Old Pine Rd
Boca Raton, FL 33428-3055
Phone (305) 297-9512

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in FL
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 1

Enrollment IDStateProvider typePAC IDDetails
I20170320002445 FL Practitioner - Clinical Social Worker 5395020085 Reassigns benefits to 2 organizations

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2013
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services

Practice addresses (Care Compare)

Boca Raton, FL 33428
Phone (305) 297-9512

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
SW13266FLMDClinical Social Worker
18912MDMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Cma Dental PLLC CurrentSince Jul 25, 2021 Accepting new patients
University of Miami CurrentSince May 5, 2020 Accepting new patients
University of Miami Current Accepting new patients
Resilience Therapy Group of South Florida, PLLC Clinical CurrentSince Jan 15, 2020 Accepting new patients
University of Miami CurrentSince May 5, 2020 Accepting new patients

Locations

7000 W Palmetto Park Rd
Ste 210
Boca Raton, FL 33433
Phone (561) 409-4490

4800 NE 20th Ter
Ste 201
Ft Lauderdale, FL 33308
Phone (305) 892-4000

1611 NW 12th Ave
Miami, FL 33136
Phone (305) 585-6226

3401 Pga Blvd
Ste 400
Palm Beach Gardens, FL 33410
Phone (561) 219-1000

Organizations & group practices 5

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.

NPI Registry JSON

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

{
    "created_epoch": "1413849600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1577923200000",
    "number": "1104220060",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "9497 OLD PINE RD",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334283055",
            "telephone_number": "305-297-9512"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "7000 W PALMETTO PARK RD STE 210",
            "city": "BOCA RATON",
            "state": "FL",
            "postal_code": "334333430",
            "telephone_number": "561-444-7222"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHKOLNIK",
        "first_name": "NIURKA",
        "middle_name": "CANELO",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-21",
        "last_updated": "2020-01-02",
        "certification_date": "2020-01-02",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MD",
            "license": "18912",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW13266",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Boca Raton, FL

Sources for this page

Verify at the official NPI Registry.