Individual provider Active NPI

Ajibola Olawanle Toye Shepherd

  • Clinical Social Worker
  • Poughkeepsie, NY
National Provider Identifier
1427769454
Registry record updated Dec 12, 2022
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
Practice address
6210 Cherry Hill Dr
Poughkeepsie, NY 12603-1707
Phone
(845) 546-1531
NPI assigned
Dec 12, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 12, 2022

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X Primary

Addresses

Primary practice location

6210 Cherry Hill Dr
Poughkeepsie, NY 12603-1707

Mailing address

6210 Cherry Hill Dr
Poughkeepsie, NY 12603-1707
Phone (845) 546-1531

Electronic endpoints 1

TypeEndpointUseAffiliation
Direct Messaging Address ajibolatoye.shepherd@cognitivehsc.com Direct

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": "1670803200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1670803200000",
    "number": "1427769454",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6210 CHERRY HILL DR",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126031707",
            "telephone_number": "845-546-1531"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6210 CHERRY HILL DR",
            "city": "POUGHKEEPSIE",
            "state": "NY",
            "postal_code": "126031707",
            "telephone_number": "845-546-1531"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "TOYE SHEPHERD",
        "first_name": "AJIBOLA",
        "middle_name": "OLAWANLE",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-12-12",
        "last_updated": "2022-12-12",
        "certification_date": "2022-12-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "DIRECT",
            "endpointTypeDescription": "Direct Messaging Address",
            "endpoint": "ajibolatoye.shepherd@cognitivehsc.com",
            "affiliation": "N",
            "use": "DIRECT",
            "useDescription": "Direct",
            "contentType": "CSV",
            "contentTypeDescription": "CSV",
            "address_1": "6210 Cherry Hill Dr",
            "city": "Poughkeepsie",
            "state": "NY",
            "country_code": "US",
            "postal_code": "126031707",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

Other providers in Poughkeepsie, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 12, 2022; 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.