Active NPI
Melissa G Shikora, LCSW
- Clinical Social Worker
- Smithtown, NY
National Provider Identifier
1316449242
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 084596-1
- Practice address
- 732 Smithtown Byp Ste 304
Smithtown, NY 11787-5020 - Phone
- (631) 291-8756
- Fax
- (631) 473-3021
- NPI assigned
- Mar 7, 2018
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 084596-1 | NY | Primary |
Addresses
Primary practice location
732 Smithtown Byp Ste 304
Smithtown, NY 11787-5020
Mailing address
119 Roosevelt Ave
Port Jefferson, NY 11777-2046
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
| License | State | Type | Specialty |
|---|---|---|---|
| 084596-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1520380800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1520380800000",
"number": "1316449242",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "119 ROOSEVELT AVE",
"city": "PORT JEFFERSON",
"state": "NY",
"postal_code": "117772046"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "732 SMITHTOWN BYP STE 304",
"city": "SMITHTOWN",
"state": "NY",
"postal_code": "117875020",
"telephone_number": "631-291-8756",
"fax_number": "631-473-3021"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHIKORA",
"first_name": "MELISSA",
"middle_name": "G",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2018-03-07",
"last_updated": "2018-03-07",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "084596-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Smithtown, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Mar 7, 2018; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.