Shantal Bishop
Individual provider Active NPI Mental Health Counselor · Roosevelt, NY
NPI 1730002643 · NPPES record last updated Jul 30, 2026
Key facts
- NPI
- 1730002643
- Entity type
- Individual (NPI type 1)
- Primary specialty
- Mental Health Counselor 101YM0800X
- License
- P144802 (NY)
- Practice address
- 80 Whitehouse Ave
Roosevelt, NY 11575-1324 - Phone
- (516) 309-1675
- Fax
- (516) 223-3840
- NPI assigned
- Jul 30, 2026
- Sex
- Female
- Sole proprietor
- Yes
Organizations & group practices 1
Medicare participation
- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
- Medicare enrollment (NPD)
- No
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Greenwood Mental Health Counseling P.C. | Mental Health | Past |
Accepting new patients |
Specialties & licenses
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | P144802 | NY | Yes |
Addresses
Primary practice location
80 Whitehouse Ave
Roosevelt, NY 11575-1324
Mailing address
1019 Van Siclen Ave Apt 4F
Brooklyn, NY 11207-9034
Phone (917) 579-1627
Other providers in Roosevelt, NY
- Laura Marie Belluomo
- Joel Bernard
- Jill Bernstein
- Donna Berry
- Alexis Bethea
- Hannah Blake
- Jennifer Bohr
- Sherry Bomze
- Jessica Bonelli
- Nancy Marie Bonelli
All providers in Roosevelt, NY · Mental Health Counselor in New York
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Record last updated by the provider on Jul 30, 2026. Information in NPPES is self-reported and not verified by CMS.
- NUCC Health Care Provider Taxonomy: specialty names.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.