Individual provider Active NPI

Shoshana Silverman Belisle, LMSW

  • Social Worker
  • Brooklyn, NY
National Provider Identifier
1235725771
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
067858 Issued in NY
Practice address
200 Prospect Park W
Brooklyn, NY 11215-5747
Phone
(212) 621-7770
NPI assigned
Dec 18, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 067858 NY Primary

Addresses

Primary practice location

200 Prospect Park W
Brooklyn, NY 11215-5747

Mailing address

632 College Hill Rd
Woodstock, VT 05091-3006
Phone (917) 494-9663

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
067858NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1608249600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1235725771",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 COLLEGE HILL RD",
            "city": "WOODSTOCK",
            "state": "VT",
            "postal_code": "050913006",
            "telephone_number": "917-494-9663"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 PROSPECT PARK W",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112155747",
            "telephone_number": "212-621-7770"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BELISLE",
        "first_name": "SHOSHANA",
        "middle_name": "SILVERMAN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-12-18",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "067858",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; 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.