Active NPI
Shelley Juran, PH.D.
- Psychologist
- Brooklyn, NY
National Provider Identifier
1922185297
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Psychologist
- License
- 6331
- Practice address
- 163 Clinton St
Brooklyn, NY 11201-4601 - Phone
- (718) 625-6526
- Fax
- (718) 596-0518
- NPI assigned
- Nov 1, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Psychologist | 103T00000X | 6331 | NY | Primary |
Addresses
Primary practice location
163 Clinton St
Brooklyn, NY 11201-4601
Mailing address
101 Clark St
#19B
Brooklyn, NY 11201-2746
Phone (718) 625-6526
Other identifiers 2
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 135819 | Other | NY | VALUE OPTIONS PROVIDER # |
| 0010987 | Other | NY | GHI PROVIDER NUMBER |
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
- Credentials
- Doctor of Philosophy
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 6331 | NY | MD | Psychologist |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1162339200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1183852800000",
"number": "1922185297",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "101 CLARK ST",
"address_2": "#19B",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112012746",
"telephone_number": "718-625-6526",
"fax_number": "718-596-0518"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "163 CLINTON ST",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112014601",
"telephone_number": "718-625-6526",
"fax_number": "718-596-0518"
}
],
"practiceLocations": [],
"basic": {
"last_name": "JURAN",
"first_name": "SHELLEY",
"name_prefix": "Dr.",
"credential": "PH.D.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-01",
"last_updated": "2007-07-08",
"status": "A"
},
"taxonomies": [
{
"code": "103T00000X",
"taxonomy_group": "",
"desc": "Psychologist",
"state": "NY",
"license": "6331",
"primary": true
}
],
"identifiers": [
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "VALUE OPTIONS PROVIDER #",
"identifier": "135819",
"state": "NY"
},
{
"code": "01",
"desc": "Other (non-Medicare)",
"issuer": "GHI PROVIDER NUMBER",
"identifier": "0010987",
"state": "NY"
}
],
"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 Jul 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.