Zachary Robert Shindorf

Primary specialty

Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X

License

PS01912 Issued in RI

Practice address

13460 Walsh Dr
Boys Town, NE 68010-7529

Phone

(531) 355-3358

Fax

(531) 355-3375

NPI assigned

May 17, 2018

Last updated

Nov 16, 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)

Enrolled

Credentials

Doctor of Philosophy

State licenses

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

{
    "created_epoch": "1526515200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1605484800000",
    "number": "1952891624",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "117 ELLENFIELD ST STE 101",
            "city": "PROVIDENCE",
            "state": "RI",
            "postal_code": "029054541",
            "telephone_number": "401-444-6779",
            "fax_number": "531-355-3375"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13460 WALSH DR",
            "city": "BOYS TOWN",
            "state": "NE",
            "postal_code": "680107529",
            "telephone_number": "531-355-3358",
            "fax_number": "531-355-3375"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SHINDORF",
        "first_name": "ZACHARY",
        "middle_name": "ROBERT",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2018-05-17",
        "last_updated": "2020-11-16",
        "certification_date": "2020-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NE",
            "license": "11459",
            "primary": false
        },
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": "RI",
            "license": "PS01912",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Amber Lynne Schramm
• Robert J Schwab, MD
• Janet Elaine Schwartz-Micheaux, PHD, LP
• Amanda Beth Setlak, LMHP AND LP
• John P Sheehan, M.D.
• Sandip Singh, LIMHP, LMHP, LADC
• David H Sjulin, M.D.
• Hannah Marie Sliman, PLMHP
• Julie Ann Slizinski
• Quinn Smith, MD

• Clinical Child & Adolescent Psychologist in Boys Town, NE
• Providers in Boys Town, NE by specialty
• Clinical Child & Adolescent Psychologist in Nebraska

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 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.