Individual provider Active NPI

Tanisha Shanika Samuel

  • Mental Health Counselor
  • Brooklyn, NY
National Provider Identifier
1417853169
Registry record updated Oct 19, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
Practice address
88 E 40TH St Apt 2
Brooklyn, NY 11203-2911
Phone
(347) 933-5301
NPI assigned
Oct 19, 2026
Last updated
Oct 19, 2026By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Oct 19, 2026

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X NY Primary

Addresses

Primary practice location

88 E 40TH St Apt 2
Brooklyn, NY 11203-2911

Mailing address

2248 Ryder St
Brooklyn, NY 11234-5116
Phone (347) 933-5301

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": "1792368000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1792368000000",
    "number": "1417853169",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "2248 RYDER ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112345116",
            "telephone_number": "347-933-5301"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "88 E 40TH ST APT 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112032911",
            "telephone_number": "347-933-5301"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SAMUEL",
        "first_name": "TANISHA",
        "middle_name": "SHANIKA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2026-10-19",
        "last_updated": "2026-10-19",
        "certification_date": "2026-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2026; 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.