Shane Mark Tull, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

074557 Issued in NY

Practice address

549 Throop Ave
3F
Brooklyn, NY 11216-2434

Phone

(947) 884-4135

Fax

(718) 576-9424

NPI assigned

Aug 9, 2006

Sex

Male

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)

Enrolled

State licenses

Practice roles

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.

• Vic Torgrimsen, LCSW PLLC

  • Clinical Social Worker
  • West Babylon, NY
  • NPI 1548548183
  NPD (past)

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

{
    "created_epoch": "1155081600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1365724800000",
    "number": "1306857230",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "549 THROOP AVE",
            "address_2": "3F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112162434",
            "telephone_number": "947-884-4135",
            "fax_number": "718-576-9424"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "549 THROOP AVE",
            "address_2": "3F",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112162434",
            "telephone_number": "947-884-4135",
            "fax_number": "718-576-9424"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TULL",
        "first_name": "SHANE",
        "middle_name": "MARK",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-08-09",
        "last_updated": "2013-04-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "074557",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Svetlana Tulchinskaya, FNP-C
• Abishek Tuli, M.D.
• Shubhangi Tuli, MBBS
• Tulip Behavioral Health LLC
• Kandace O Tulk, PA
• Katrina Tulla, DO
• Jonathan Tuller
• Monica A Tullier, APRN
• Veltareen Evadne Tulloch - Sparkes, LPN
• Andrew Tulloch, RN

• Clinical Social Worker in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 12, 2013; 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.