Healthcare Provider Details

I. General information

NPI: 1639366453
Provider Name (Legal Business Name): KALA PILLAI SHANKER LCSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

Provider Other Name: KAMALAKSHI PILLAI SHANKER LCSW

II. Dates (important events)

Enumeration Date: 09/25/2007
Last Update Date: 07/24/2026
Certification Date: 07/24/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

1329 BEACH CHANNEL DR
FAR ROCKAWAY NY
11691-3211
US

IV. Provider business mailing address

9 CARDINAL LN
EAST NORTHPORT NY
11731-5301
US

V. Phone/Fax

Practice location:
  • Phone: 718-337-6800
  • Fax:
Mailing address:
  • Phone: 516-376-5341
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number103431
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: