Individual provider Active NPI

Shibinsky Latoya Payne, LCSW

  • Clinical Social Worker
  • East Northport, NY
National Provider Identifier
1841552650
Registry record updated Sep 9, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
079329-1 Issued in NY
Practice address
206 Clay Pitts Rd
East Northport, NY 11731-3423
Phone
(631) 926-8690
NPI assigned
Jun 8, 2012
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 9, 2020

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 079329-1 NY Primary

Addresses

Primary practice location

206 Clay Pitts Rd
East Northport, NY 11731-3423

Mailing address

206 Clay Pitts Rd
East Northport, NY 11731-3423
Phone (631) 926-8690

Other practice location 1

760 Broadway
Brooklyn, NY 11206-5317
Phone (718) 963-8000 ext. 8070

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
079329-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1339113600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1599609600000",
    "number": "1841552650",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "206 CLAY PITTS RD",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117313423",
            "telephone_number": "631-926-8690"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "206 CLAY PITTS RD",
            "city": "EAST NORTHPORT",
            "state": "NY",
            "postal_code": "117313423",
            "telephone_number": "631-926-8690"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "760 Broadway",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112065317",
            "country_code": "US",
            "telephone_number": "718-963-8000 x8070",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "PAYNE",
        "first_name": "SHIBINSKY",
        "middle_name": "LATOYA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-06-08",
        "last_updated": "2020-09-09",
        "certification_date": "2020-09-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "079329-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in East Northport, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 9, 2020; 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.