Individual provider Active NPI

Shawn L Forde, LCSW

  • Clinical Social Worker
  • New Rochelle, NY
National Provider Identifier
1144679267
Registry record updated Sep 27, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
093068 Issued in NY
Practice address
735 Pelham Rd
New Rochelle, NY 10805-1103
Phone
(917) 836-8206
NPI assigned
Jun 9, 2016
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Sep 27, 2024

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 093068 NY Primary

Addresses

Primary practice location

735 Pelham Rd
New Rochelle, NY 10805-1103

Mailing address

735 Pelham Rd
New Rochelle, NY 10805-1103
Phone (917) 836-8206

Other practice location 1

6002 Queens Blvd
Lower Level
Woodside, NY 11377-4973
Phone (917) 836-8206

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
093068NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1465430400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1727395200000",
    "number": "1144679267",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "735 PELHAM RD",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108051103",
            "telephone_number": "917-836-8206"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "735 PELHAM RD",
            "city": "NEW ROCHELLE",
            "state": "NY",
            "postal_code": "108051103",
            "telephone_number": "917-836-8206"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "6002 Queens Blvd",
            "address_2": "Lower Level",
            "address_purpose": "LOCATION",
            "city": "Woodside",
            "state": "NY",
            "postal_code": "113774973",
            "country_code": "US",
            "telephone_number": "917-836-8206",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "FORDE",
        "first_name": "SHAWN",
        "middle_name": "L",
        "name_prefix": "Miss",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2016-06-09",
        "last_updated": "2024-09-27",
        "certification_date": "2024-09-27",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "093068",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in New Rochelle, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 27, 2024; 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.