Individual provider Active NPI

Madeline Shill, LCSW

  • Clinical Social Worker
  • New York, NY
National Provider Identifier
1760969877
Registry record updated Oct 23, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
092125 Issued in NY
Practice address
139 Fulton St RM 902
New York, NY 10038-2531
Phone
(201) 783-3409
NPI assigned
Jul 21, 2018
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 23, 2024

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 092125 NY Primary

Addresses

Primary practice location

139 Fulton St RM 902
New York, NY 10038-2531

Mailing address

139 Fulton St RM 902
New York, NY 10038-2531
Phone (201) 783-3409

Other practice location 1

111 Broadway Ste 905
New York, NY 10006-1901
Phone (929) 379-6386

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
092125NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Be You Psychotherapy, LCSW, PLLC Clinical CurrentSince Jul 3, 2022 Accepting new patients

Locations

139 Fulton St
Rm 902
New York, NY 10038
Phone (917) 342-2538

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1532131200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1729641600000",
    "number": "1760969877",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "139 FULTON ST RM 902",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100382531",
            "telephone_number": "201-783-3409"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "139 FULTON ST RM 902",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100382531",
            "telephone_number": "201-783-3409"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "111 Broadway Ste 905",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100061901",
            "country_code": "US",
            "telephone_number": "929-379-6386",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SHILL",
        "first_name": "MADELINE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-07-21",
        "last_updated": "2024-10-23",
        "certification_date": "2024-10-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "092125",
            "primary": true
        }
    ],
    "identifiers": [],
    "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 Oct 23, 2024; 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.