Individual provider Active NPI

Shifti Shami Kamal

  • Social Worker
  • Brooklyn, NY
National Provider Identifier
1821798794
Registry record updated Mar 8, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
119122-01 Issued in NY
Practice address
541 Bay Ridge Pkwy
Brooklyn, NY 11209-3309
Phone
(929) 200-3049
NPI assigned
Mar 8, 2023
Last updated
Mar 8, 2023By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 8, 2023

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 119122-01 NY Primary

Addresses

Primary practice location

541 Bay Ridge Pkwy
Brooklyn, NY 11209-3309

Mailing address

541 Bay Ridge Pkwy
Brooklyn, NY 11209-3309
Phone (929) 200-3049

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
119122-01NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Resilient Mind Licensed Clinical Social Work Services, PC Social Worker CurrentSince Apr 20, 2025 Accepting new patients

Locations

541 Bay Ridge Pkwy
Brooklyn, NY 11209
Phone (718) 748-6451

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, 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": "1678233600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1678233600000",
    "number": "1821798794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "541 BAY RIDGE PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112093309",
            "telephone_number": "929-200-3049"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "541 BAY RIDGE PKWY",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112093309",
            "telephone_number": "929-200-3049"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHAMI KAMAL",
        "first_name": "SHIFTI",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-03-08",
        "last_updated": "2023-03-08",
        "certification_date": "2023-03-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "119122-01",
            "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 Mar 8, 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.