Healthcare Provider Details

I. General information

NPI: 1316195837
Provider Name (Legal Business Name): SHAYLA MICHELLE HILT LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: Y

II. Dates (important events)

Enumeration Date: 09/09/2008
Last Update Date: 10/13/2024
Certification Date: 10/13/2024
Deactivation Date:
Reactivation Date:

III. Provider practice location address

829 GREENWOOD AVE
BROOKLYN NY
11218-1349
US

IV. Provider business mailing address

875 4TH AVE APT 103
BROOKLYN NY
11232-2186
US

V. Phone/Fax

Practice location:
  • Phone: 347-721-0654
  • Fax:
Mailing address:
  • Phone: 347-721-0654
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number082110-1
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: