Individual provider Active NPI

Lionel R Shockness, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1205069986
Registry record updated Aug 28, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R049379-1 Issued in NY
Practice address
75 Maiden LN
Suite 320
New York, NY 10038-4810
Phone
(212) 579-6294
Fax
(212) 865-7183
NPI assigned
Aug 28, 2009
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Aug 28, 2009

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 R049379-1 NY Primary
Clinical Social Worker 1041C0700X

Addresses

Primary practice location

75 Maiden LN
Suite 320
New York, NY 10038-4810

Mailing address

75 Maiden LN
Suite 320
New York, NY 10038-4810
Phone (212) 579-6294

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
R049379-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1251417600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1251417600000",
    "number": "1205069986",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "75 MAIDEN LN",
            "address_2": "SUITE 320",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384810",
            "telephone_number": "212-579-6294",
            "fax_number": "212-865-7183"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "75 MAIDEN LN",
            "address_2": "SUITE 320",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100384810",
            "telephone_number": "212-579-6294",
            "fax_number": "212-865-7183"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHOCKNESS",
        "first_name": "LIONEL",
        "middle_name": "R",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2009-08-28",
        "last_updated": "2009-08-28",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R049379-1",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": false
        }
    ],
    "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 28, 2009; 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.