Healthcare Provider Details

I. General information

NPI: 1700274388
Provider Name (Legal Business Name): MALIKAH Z SHAHEED MSW
Entity Type: Individual
Gender: Female
Sole Proprietor: N

II. Dates (important events)

Enumeration Date: 01/05/2015
Last Update Date: 07/18/2026
Certification Date: 07/18/2026
Deactivation Date:
Reactivation Date:

III. Provider practice location address

PO BOX 969
UTICA NY
13503-0969
US

IV. Provider business mailing address

85 ROSEMARY AVE
BUFFALO NY
14216-1614
US

V. Phone/Fax

Practice location:
  • Phone: 518-763-1651
  • Fax:
Mailing address:
  • Phone: 518-283-6500
  • Fax:

VI. Provider taxonomy

Scope of Practice (Provider specialty)

# 1
Primary TaxonomyY
Taxonomy Code1041C0700X
TaxonomyClinical Social Worker
License Number101442
License Number StateNY

VIII. Authorized Official

Name:
Title or Position:
Credential:
Phone: