NPIMap

Organization Active NPI

Shiloh Consulting LLC

  • Forensic Psychologist
  • New York, NY
National Provider Identifier
1659500577
Registry record updated Aug 2, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Forensic PsychologistTaxonomy code 103TF0200X
License
012747-1 Issued in NY
Legal business name
SHILOH CONSULTING LLC
Practice address
566 7TH Ave FL 4
New York, NY 10018-1802
Phone
(212) 564-7631
Fax
(212) 564-7819
NPI assigned
Jul 13, 2009
Organization subpart
No

NPPES NPI Registry

Updated by the provider on Aug 2, 2023

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

Authorized official

Name
Dr. Kay E Jackson, PSYCHOLOGISTNPI 1417127945
Title
Executive Director
Phone
(212) 564-7631

Authorized official NPPES reports the official by name only. The link goes to the one practitioner connected to this organization with that name.

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Forensic PsychologistGroup: 193400000X SINGLE SPECIALTY GROUP 103TF0200X 012747-1 NY Primary

Addresses

Primary practice location

566 7TH Ave FL 4
New York, NY 10018-1802

Mailing address

566 7TH Ave FL 4
New York, NY 10018-1802
Phone (212) 564-7631

Other practice location 1

300 Community Dr
Manhasset, NY 11030-3816
Phone (212) 562-3603

Other practice location 2

300 Cadman Plz W
Brooklyn, NY 11201-3229
Phone (718) 822-1818

Other identifiers 1

IdentifierTypeStateIssuer
02966163MedicaidNY

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
O20120515000258 NY Part B Supplier - Clinic/Group Practice 2062675887 Receives reassigned benefits from 3 practitioners
Practice locations: New York, NY

National Provider Directory

National Provider Directory

Locations

214 W 29th St
Rm 703
New York, NY 10001
Phone (212) 564-7631

Practitioners & affiliated clinicians

Practitioners 13

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

View all 13

NPI Registry JSON

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

{
    "created_epoch": "1247443200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1690934400000",
    "number": "1659500577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "566 7TH AVE FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100181802",
            "telephone_number": "212-564-7631",
            "fax_number": "212-564-7819"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "566 7TH AVE FL 4",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100181802",
            "telephone_number": "212-564-7631",
            "fax_number": "212-564-7819"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "300 Community Dr",
            "address_purpose": "LOCATION",
            "city": "Manhasset",
            "state": "NY",
            "postal_code": "110303816",
            "country_code": "US",
            "telephone_number": "212-562-3603",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "300 Cadman Plz W",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112013229",
            "country_code": "US",
            "telephone_number": "718-822-1818",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "SHILOH CONSULTING LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2009-07-13",
        "last_updated": "2023-08-02",
        "certification_date": "2023-08-02",
        "status": "A",
        "authorized_official_last_name": "JACKSON",
        "authorized_official_first_name": "KAY",
        "authorized_official_middle_name": "E",
        "authorized_official_title_or_position": "EXECUTIVE DIRECTOR",
        "authorized_official_telephone_number": "212-564-7631",
        "authorized_official_name_prefix": "Dr.",
        "authorized_official_credential": "PSYCHOLOGIST"
    },
    "taxonomies": [
        {
            "code": "103TF0200X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Psychologist, Forensic",
            "state": "NY",
            "license": "012747-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02966163",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in New York, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 2, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
  • Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
  • National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.