Mary Ellen Rita Shea, LSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Practice address

860 Wyckoff Ave
Mahwah, NJ 07430-3186

Phone

(201) 485-7172

NPI assigned

Feb 13, 2018

Last updated

Feb 13, 2018By the provider in NPPES

Sex

Female

Sole proprietor

Yes

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

Practice roles

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

• West Bergen Mental Healthcare, Inc.

  • Clinic/Center
  • Ridgewood, NJ
  • NPI 1881755973

  Clinical

  NPD (past)

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

{
    "created_epoch": "1518480000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1518480000000",
    "number": "1720588007",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "860 WYCKOFF AVE",
            "city": "MAHWAH",
            "state": "NJ",
            "postal_code": "074303186",
            "telephone_number": "201-637-4997"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "860 WYCKOFF AVE",
            "city": "MAHWAH",
            "state": "NJ",
            "postal_code": "074303186",
            "telephone_number": "201-485-7172"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHEA",
        "first_name": "MARY ELLEN",
        "middle_name": "RITA",
        "name_prefix": "Mrs.",
        "credential": "LSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-02-13",
        "last_updated": "2018-02-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Select Physical Therapy Holdings Inc
• Song Woo Seo, DPM
• Morteza Shahamat, MD
• Madeeha Shahzadi, MD
• Indu Sharma, M.D.
• Gary Allan Shiffman, P.T.
• Corinne Shustyk, PT, DPT
• Christine Marie Soderman
• Angela K Song
• Hayley Spector, PSY.D.

• Clinical Social Worker in Mahwah, NJ
• Providers in Mahwah, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 13, 2018; 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.