Shabieko Shannon Ivy

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

P113453 Issued in NY

Practice address

493 Nostrand Ave Ste 3
Brooklyn, NY 11216-5118

Phone

(718) 230-1379

NPI assigned

Jan 6, 2022

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

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.

• Family Center Inc

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Brooklyn, NY
  • NPI 1114603594
  NPD
• Family Center Inc

  • Community/Behavioral Health Agency
  • Brooklyn, NY
  • NPI 1275963720
  NPD

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

{
    "created_epoch": "1641427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1641427200000",
    "number": "1639830003",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "493 NOSTRAND AVE STE 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112165118",
            "telephone_number": "718-230-1379"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "493 NOSTRAND AVE STE 3",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112165118",
            "telephone_number": "718-230-1379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IVY",
        "first_name": "SHABIEKO",
        "middle_name": "SHANNON",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2022-01-06",
        "last_updated": "2022-01-06",
        "certification_date": "2022-01-06",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "P113453",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Ilatisha Ivey
• Ivory Inc
• Leah Ivory
• Ivs Pharmacy Corp
• Kristina Lynn Ivy, MD
• Ivymaze, LLC
• Emily Iwamoto, LCSW
• Joseph Iwanicki, M.D.
• Erin Iwanusa, LCSW
• Iwig Inc.

• Clinical Social Worker in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jan 6, 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.