Individual provider Active NPI

Shauntee' Latriece Byron, MSCJ, LMSW, DSW SIFI

  • Social Worker
  • Bronx, NY
National Provider Identifier
1619759016
Registry record updated Oct 19, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
112332-01 Issued in NY
Practice address
390 E 158TH St Apt 2F
Bronx, NY 10451-4468
Phone
(347) 972-3273
NPI assigned
Oct 19, 2023
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 19, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 112332-01 NY Primary

Addresses

Primary practice location

390 E 158TH St Apt 2F
Bronx, NY 10451-4468

Mailing address

390 E 158TH St Apt 2F
Bronx, NY 10451-4468
Phone (347) 972-3273

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

State licenses

LicenseStateTypeSpecialty
112332-01NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1697673600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1697673600000",
    "number": "1619759016",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "390 E 158TH ST APT 2F",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104514468",
            "telephone_number": "347-972-3273"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "390 E 158TH ST APT 2F",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104514468",
            "telephone_number": "347-972-3273"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "BYRON",
        "first_name": "SHAUNTEE'",
        "middle_name": "LATRIECE",
        "name_prefix": "Dr.",
        "credential": "MSCJ, LMSW, DSW SIFI",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2023-10-19",
        "last_updated": "2023-10-19",
        "certification_date": "2023-10-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "112332-01",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 19, 2023; 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.