Individual provider Active NPI

Stephanie Shelton, LMSW

  • Social Worker
  • Brooklyn, NY
National Provider Identifier
1740421577
Registry record updated Apr 3, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
106118-1 Issued in NY
Practice address
1125 Fulton St Ste 2
Brooklyn, NY 11238-2669
Phone
(347) 226-9025
NPI assigned
Mar 6, 2009
Last updated
Apr 3, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Apr 3, 2023

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Addiction (Substance Use Disorder) Counselor 101YA0400X NU
Social Worker 104100000X 106118-1 NY Primary

Addresses

Primary practice location

1125 Fulton St Ste 2
Brooklyn, NY 11238-2669

Mailing address

1125 Fulton St Ste 2
Brooklyn, NY 11238-2669
Phone (347) 226-9025

Other practice location 1

19 Union Sq W
7th Floor
New York, NY 10003-3304
Phone (212) 627-9600

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
106118-1NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Sus Mental Health Programs, Inc. CurrentSince Apr 9, 2023 Accepting new patients
Realization Center, Inc. PastSince Sep 1, 2015 Accepting new patients
Realization Center Past Accepting new patients

Locations

1125 Fulton St
Ste 2
Brooklyn, NY 11238
Phone (347) 226-9025

Organizations & group practices 3

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.

NPI Registry JSON

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

{
    "created_epoch": "1236297600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1680480000000",
    "number": "1740421577",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1125 FULTON ST STE 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112382669",
            "telephone_number": "347-226-9025",
            "fax_number": "212-627-4040"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1125 FULTON ST STE 2",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112382669",
            "telephone_number": "347-226-9025"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "19 Union Sq W",
            "address_2": "7th Floor",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100033304",
            "country_code": "US",
            "telephone_number": "212-627-9600",
            "fax_number": "212-627-4040",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHELTON",
        "first_name": "STEPHANIE",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2009-03-06",
        "last_updated": "2023-04-03",
        "certification_date": "2023-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YA0400X",
            "taxonomy_group": "",
            "desc": "Counselor, Addiction (Substance Use Disorder)",
            "state": "NU",
            "license": null,
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "106118-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 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.