Shantel Phillips, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

092647 Issued in NY

Practice address

141 Broadway
Newburgh, NY 12550-6204

Phone

(845) 568-5264

Fax

(845) 378-3284

NPI assigned

Jul 29, 2022

Last updated

Aug 25, 2023By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Enrolled in NY

Eligible to order & refer

• Part B services: Yes
• Medical equipment: Yes
• Home health: No
• Power mobility devices: No
• Hospice: No

Green means eligible to order or refer.

Enrollment records 1

Specialty

Clinical Social Worker

Education

Other, 2017

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

County of OrangeGroup PAC ID 0648169185, 28 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• County of Orange

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Port Jervis, NY
  • NPI 1740227214
  Medicare reassignment Care Compare group NPD
• Nassau Psychology, P.C.

  • Psychologist
  • Lynbrook, NY
  • NPI 1750763538
  Medicare reassignment NPD
• County of Orange

  dba The Valley View Certified Home Health Agency

  • Home Health Agency
  • Goshen, NY
  • NPI 1073016952
  NPD
• County of Orange

  dba Orange County Dept. of Mental Health

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Newburgh, NY
  • NPI 1295889806
  NPD

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

{
    "created_epoch": "1659052800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1692921600000",
    "number": "1376279588",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "141 BROADWAY",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125506204",
            "telephone_number": "845-568-5264",
            "fax_number": "845-378-3284"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "141 BROADWAY",
            "city": "NEWBURGH",
            "state": "NY",
            "postal_code": "125506204",
            "telephone_number": "845-568-5264",
            "fax_number": "845-378-3284"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "PHILLIPS",
        "first_name": "SHANTEL",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-07-29",
        "last_updated": "2023-08-25",
        "certification_date": "2023-08-25",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "092647",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "Avatar",
            "affiliation": "N",
            "endpointDescription": "EHR",
            "use": "HIE",
            "useDescription": "Health Information Exchange (HIE)",
            "contentType": "OTHER",
            "contentTypeDescription": "Other",
            "contentOtherDescription": "N/A",
            "address_1": "141 Broadway",
            "city": "Newburgh",
            "state": "NY",
            "country_code": "US",
            "postal_code": "125506204",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Geraldine Petrosino, D.M.D.
• Jonathan Peyton
• Jessica Pforte
• Tyler Phan, O.D.
• Yolanda Phillip, FNP
• Frederick Joseph Philo III
• Phoenix Mental Health Counseling, PLLC
• Physical Medicine & Rehabilitation SVCS. of Ny P.C.
• Physician at Newburgh
• Jill Elizabeth Pichardo

• Clinical Social Worker in Newburgh, NY
• Providers in Newburgh, 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 Aug 25, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.