Kazeem Shinaba

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

0898667 Issued in NY

Practice address

1420 Bushwick Ave # 334
Brooklyn, NY 11207-1422

Phone

(347) 770-9911

NPI assigned

Jul 13, 2018

Last updated

Sep 19, 2020By the provider in NPPES

Sex

Male

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1531440000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1600473600000",
    "number": "1952887853",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1420 BUSHWICK AVE # 334",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112071422"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1420 BUSHWICK AVE # 334",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112071422",
            "telephone_number": "347-770-9911"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINABA",
        "first_name": "KAZEEM",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-07-13",
        "last_updated": "2020-09-19",
        "certification_date": "2020-09-19",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "096406-1",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "0898667",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Mike Shin, MD
• Richard D Shin, M.D.
• Soonye Shin, NURSE PRACTITIONER
• Wonyoung Shin
• Yoon Shin, MD
• Amanda Shinall, PA
• Danna Shinaver
• Anna Shindelman, MD
• Dmitry Shindelman, CPNP
• Pavel Shinder, RPH

• Clinical Social Worker in Brooklyn, NY
• Providers in Brooklyn, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 19, 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.