Healthcare Provider Details

I. General information

NPI: 1053227322
Provider Name (Legal Business Name): EVERYBODY'S PLACE, LCSW PLLC
Entity Type: Organization
Gender:
Sole Proprietor:

II. Dates (important events)

Enumeration Date: 08/19/2026
Last Update Date: 08/26/2026
Certification Date: 08/26/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

18 E 41ST ST STE 906
NEW YORK NY
10017-6222
US

IV. Provider business mailing address

18 E 41ST ST STE 906
NEW YORK NY
10017-6222
US

V. Phone/Fax

Practice location:
  • Phone: 917-960-8737
  • Fax:
Mailing address:
  • Phone:
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number
License Number State

VIII. Authorized Official

Name: ANTOINETTE BONAFEDE SHINE
Title or Position: CLINICAL DIRECTOR
Credential: LCSW
Phone: 917-960-8737