Healthcare Provider Details

I. General information

NPI: 1407748890
Provider Name (Legal Business Name): SHATTER HEALTH, LLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 07/18/2025
Last Update Date: 04/17/2026
Certification Date: 04/17/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

4400 MACARTHUR BLVD NW STE 300
WASHINGTON DC
20007-2521
US

IV. Provider business mailing address

4400 MACARTHUR BLVD NW STE 300
WASHINGTON DC
20007-2521
US

V. Phone/Fax

Practice location:
  • Phone: 202-361-2453
  • Fax: 888-830-6376
Mailing address:
  • Phone: 202-361-2453
  • Fax: 888-830-6376

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyN
Taxonomy Code101YM0800X
TaxonomyMental Health Counselor
License Number
License Number State
# 2
Primary TaxonomyN
Taxonomy Code101YP2500X
TaxonomyProfessional Counselor
License Number
License Number State
# 3
Primary TaxonomyN
Taxonomy Code103T00000X
TaxonomyPsychologist
License Number
License Number State
# 4
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: MR. MICHAEL AMIT KAPOOR
Title or Position: OWNER
Credential:
Phone: 202-361-2453