Active NPI
Princy Shyam, MA., MSW, LCSW
- Clinical Social Worker
- Bloomingdale, IL
National Provider Identifier
1922386093
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149.014772
- Practice address
- 109 Fairfield Way
Suite 106
Bloomingdale, IL 60108-1583 - Phone
- (630) 506-2050
- NPI assigned
- Jul 23, 2011
- 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 |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 149.014772 | IL | Primary |
Addresses
Primary practice location
109 Fairfield Way
Suite 106
Bloomingdale, IL 60108-1583
Mailing address
109 Fairfield Way
Suite 106
Bloomingdale, IL 60108-1583
Phone (630) 506-2050
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
- Credentials
- Master of Arts
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 149.014772 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1311379200000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1353283200000",
"number": "1922386093",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "109 FAIRFIELD WAY",
"address_2": "SUITE 106",
"city": "BLOOMINGDALE",
"state": "IL",
"postal_code": "601081583",
"telephone_number": "630-506-2050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "109 FAIRFIELD WAY",
"address_2": "SUITE 106",
"city": "BLOOMINGDALE",
"state": "IL",
"postal_code": "601081583",
"telephone_number": "630-506-2050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "SHYAM",
"first_name": "PRINCY",
"name_prefix": "Mrs.",
"credential": "MA., MSW, LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-07-23",
"last_updated": "2012-11-19",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.014772",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Bloomingdale, IL
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 19, 2012; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.