Shanae Monique Maitland

Primary specialty

Student in an Organized Health Care Education/Training ProgramTaxonomy code 390200000X

Practice address

619 Broadway Unit 4
Amityville, NY 11701-2149

Phone

(347) 206-0733

NPI assigned

Aug 31, 2022

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

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.

• Renewed Life Mental Health Counseling

  • Mental Health Counselor
  • Amityville, NY
  • NPI 1366161762
  NPD

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

{
    "created_epoch": "1661904000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1661904000000",
    "number": "1225758162",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "116 BROADWAY STE 3",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012797",
            "telephone_number": "631-640-2088"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "619 BROADWAY UNIT 4",
            "city": "AMITYVILLE",
            "state": "NY",
            "postal_code": "117012149",
            "telephone_number": "347-206-0733"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MAITLAND",
        "first_name": "SHANAE",
        "middle_name": "MONIQUE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-08-31",
        "last_updated": "2022-08-31",
        "certification_date": "2022-08-31",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "390200000X",
            "taxonomy_group": "",
            "desc": "Student in an Organized Health Care Education/Training Program",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Lauren Nicole Macy, LMCW
• Michelle Madison, LCSW
• Deborah Joyce Magnani, MSPT
• Lauren Michelle Maiorini, D.O.
• Michael T Maiorino, D.D.S.
• Juan E Maldonado
• Lizania Maldonado
• Kevin Malone, PHARM D.
• Luise Ira Mamba, CTRS
• Alyssa M Mancuso

• Student in an Organized Health Care Education/Training Program in Amityville, NY
• Providers in Amityville, NY by specialty
• Student in an Organized Health Care Education/Training Program in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 31, 2022; 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.