Active NPI
Shelly Cepeda, LCSW
- Mental Health Counselor
- Lido Beach, NY
National Provider Identifier
1518172220
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 078784
- Practice address
- 235 Lido Blvd
Lido Beach, NY 11561-5092 - Phone
- (516) 897-2143
- NPI assigned
- May 14, 2007
- Last updated
- Oct 10, 2012
- Sex
- Female
- Sole proprietor
- No
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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 078784 | NY | Primary |
Addresses
Primary practice location
235 Lido Blvd
Lido Beach, NY 11561-5092
Mailing address
235 Lido Blvd
Lido Beach, NY 11561-5092
Phone (516) 897-2143
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)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 078784 | NY | MD | Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1179100800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1349827200000",
"number": "1518172220",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "235 LIDO BLVD",
"city": "LIDO BEACH",
"state": "NY",
"postal_code": "115615092",
"telephone_number": "516-897-2143"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "235 LIDO BLVD",
"city": "LIDO BEACH",
"state": "NY",
"postal_code": "115615092",
"telephone_number": "516-897-2143"
}
],
"practiceLocations": [],
"basic": {
"last_name": "CEPEDA",
"first_name": "SHELLY",
"name_prefix": "Mrs.",
"credential": "LCSW",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2007-05-14",
"last_updated": "2012-10-10",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "078784",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Lido Beach, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 10, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.