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NPI Code Detail

MEDICARE: MS. SHAWN K PORTNER LCSW

MEDICARE: MS. SHAWN K PORTNER LCSW
Medicare Provider Information

Scope of Practice

The following information about the specialty of the provider is available:

# Taxonomy Code Taxonomy License Number License Number State
11041C0700XClinical Social Worker077024NY
21041C0700XClinical Social Worker071071NY

General Provider Information

NPI Number : 1730266933
Entity Type Code : Individual
Provider Name (Legal Business Name) : MS. SHAWN K PORTNER LCSW
Provider Business Mailing Address
First Line : 133 ESSEX ST
Second Line : UNIT 302
City : NEW YORK
State : NY
Zip : 10002-2380
Country : US
Telephone Number :
Fax Number :
Provider Business Practice Location Address
First Line : 333 AVENUE X
Second Line :
City : BROOKLYN
State : NY
Zip : 11223-5947
Country : US
Telephone Number : 718-339-5300
Fax Number :
Authorized Official
Title or Position :
Name :
Credential :
Telephone Number :
Provider Enumeration Date : 11/01/2006
Last Update Date : 10/26/2009

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Directions to “ MS. SHAWN K PORTNER LCSW” Practice Location

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