Active NPI
Shana Fontaine
- Clinical Social Worker
- New York, NY
National Provider Identifier
1114178209
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 44SC05696500
- Practice address
- 1301 5TH Ave
New York, NY 10029-3119 - Phone
- (212) 426-3400
- NPI assigned
- Oct 7, 2008
- Sex
- Female
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 44SC05696500 | NJ | Primary |
Addresses
Primary practice location
1301 5TH Ave
New York, NY 10029-3119
Mailing address
104 Sanford PL
Newark, NJ 07106-3316
Phone (347) 972-5221
Other practice location 1
1585 Springfield Ave Ste 2
Maplewood, NJ 07040-2857
Phone (347) 972-5221
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: Yes
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1223337600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1787702400000",
"number": "1114178209",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "104 SANFORD PL",
"city": "NEWARK",
"state": "NJ",
"postal_code": "071063316",
"telephone_number": "347-972-5221"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "1301 5TH AVE",
"city": "NEW YORK",
"state": "NY",
"postal_code": "100293119",
"telephone_number": "212-426-3400"
}
],
"practiceLocations": [
{
"address_1": "1585 Springfield Ave Ste 2",
"address_purpose": "LOCATION",
"city": "Maplewood",
"state": "NJ",
"postal_code": "070402857",
"country_code": "US",
"telephone_number": "347-972-5221",
"country_name": "United States",
"address_type": "DOM"
}
],
"basic": {
"last_name": "FONTAINE",
"first_name": "SHANA",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2008-10-07",
"last_updated": "2026-08-26",
"certification_date": "2026-08-26",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NJ",
"license": "44SC05696500",
"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 Aug 26, 2026; 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.