Individual provider Active NPI

Shane Verderame-Malachowski

  • Doula
  • Southington, CT
National Provider Identifier
1346159613
Registry record updated Sep 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
DoulaTaxonomy code 374J00000X
License
25228495 Issued in CT
Practice address
1103 W Center Street Ext
Southington, CT 06489-2151
Phone
(860) 919-6794
NPI assigned
Sep 3, 2026
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 3, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Doula 374J00000X 25228495 CT Primary

Addresses

Primary practice location

1103 W Center Street Ext
Southington, CT 06489-2151

Mailing address

1103 W Center Street Ext
Southington, CT 06489-2151
Phone (860) 919-6794

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

NPI Registry JSON

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

{
    "created_epoch": "1788393600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1788393600000",
    "number": "1346159613",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1103 W CENTER STREET EXT",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064892151",
            "telephone_number": "860-919-6794"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1103 W CENTER STREET EXT",
            "city": "SOUTHINGTON",
            "state": "CT",
            "postal_code": "064892151",
            "telephone_number": "860-919-6794"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "VERDERAME-MALACHOWSKI",
        "first_name": "SHANE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2026-09-03",
        "last_updated": "2026-09-03",
        "certification_date": "2026-09-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "374J00000X",
            "taxonomy_group": "",
            "desc": "Doula",
            "state": "CT",
            "license": "25228495",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Southington, CT

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 3, 2026; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.

Verify at the official NPI Registry.