Individual provider Active NPI

Rosana Shields, LMHC

  • Mental Health Counselor
  • Rego Park, NY
National Provider Identifier
1588088124
Registry record updated Feb 18, 2014
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
005566 Issued in NY
Practice address
98120 Queens Blvd
Rego Park, NY 11374-4357
Phone
(718) 830-0246
Fax
(718) 830-9088
NPI assigned
Feb 18, 2014
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 18, 2014

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 005566 NY Primary

Addresses

Primary practice location

98120 Queens Blvd
Rego Park, NY 11374-4357

Mailing address

98120 Queens Blvd
Rego Park, NY 11374-4357

Medicare participation

Medicare enrollment files
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

Enrollment IDStateProvider typePAC IDDetails
I20240213003104 NY Practitioner - Mental Health Counselor 0446693824 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
005566NYMDOptometrist

Practice roles

OrganizationSpecialtyStatusNew patients
Comprehensive Counseling LCSW, PLLC Mental Health CurrentSince Jan 1, 2024 Accepting new patients

Locations

2 Main St
Ste 2A
Plymouth, MA 02360

3635 Bell Blvd
Ste 203
Bayside, NY 11361
Phone (718) 504-9256

98120 Queens Blvd
Ste 1C
Rego Park, NY 11374
Phone (718) 268-9598

Organizations & group practices 1

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

NPI Registry JSON

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

{
    "created_epoch": "1392681600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1392681600000",
    "number": "1588088124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "98120 QUEENS BLVD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744357"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "98120 QUEENS BLVD",
            "city": "REGO PARK",
            "state": "NY",
            "postal_code": "113744357",
            "telephone_number": "718-830-0246",
            "fax_number": "718-830-9088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHIELDS",
        "first_name": "ROSANA",
        "name_prefix": "Mrs.",
        "credential": "LMHC",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2014-02-18",
        "last_updated": "2014-02-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "NY",
            "license": "005566",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Rego Park, NY

Sources for this page

Verify at the official NPI Registry.