Individual provider Active NPI

Shameika Patrice Cunningham, LMSW

  • Social Worker
  • Staten Island, NY
National Provider Identifier
1265687420
Registry record updated Dec 1, 2008
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
Practice address
632 Ilyssa Way
Staten Island, NY 10312-1374
Phone
(917) 459-7959
NPI assigned
Dec 1, 2008
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 1, 2008

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 NY Primary

Addresses

Primary practice location

632 Ilyssa Way
Staten Island, NY 10312-1374

Mailing address

632 Ilyssa Way
Staten Island, NY 10312-1374
Phone (917) 459-7959

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

NPI Registry JSON

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

{
    "created_epoch": "1228089600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1228089600000",
    "number": "1265687420",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "632 ILYSSA WAY",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103121374",
            "telephone_number": "917-459-7959"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "632 ILYSSA WAY",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103121374",
            "telephone_number": "917-459-7959"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUNNINGHAM",
        "first_name": "SHAMEIKA",
        "middle_name": "PATRICE",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2008-12-01",
        "last_updated": "2008-12-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Staten Island, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 1, 2008; 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.