Healthcare Provider Details

I. General information

NPI: 1316052731
Provider Name (Legal Business Name): YOGESH M SHINGALA LCSWR
Entity Type: Individual
Gender: Male
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 08/19/2006
Last Update Date: 07/08/2007
Certification Date:
Deactivation Date:
Reactivation Date:

III. Provider practice location address

510 HAIGHT AVENUE SUITE 203 SPECTRUM BEHAVIORAL MANAGEMENT SERV INC
POUGHKEEPSIE NY
12603-2408
US

IV. Provider business mailing address

20 DAVIS AVENUE
POUGHKEEPSIE NY
12603-2408
US

V. Phone/Fax

Practice location:
  • Phone: 845-485-3500
  • Fax: 845-485-8780
Mailing address:
  • Phone: 845-485-3500
  • Fax: 845-485-8780

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License NumberR044021
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: