MS. SHELLY DAVIDOR, LCSW - NPI NUMBER 1780875203

Summary

Provider Name: MS. SHELLY DAVIDOR, LCSW

NPI Number: 1780875203

Clasification: Social Worker (104100000X)

Address:
255 15TH ST
SUITE 103, BASEMENT LEVEL
BROOKLYN, NY
ZIP 11215

Phone Number: (718) 788-5101



Detailed Information

MS. Shelly Davidor, LCSW is a social worker in Brooklyn, NY. The provider is a social worker is a person who is qualified by a Social Work degree, and licensed, certified or registered by the state as a social worker to practice within the scope of that license. A social worker provides assistance and counseling to clients and their families who are dealing with social, emotional and environmental problems. Social work services may be rendered to individuals, families, groups, and the public. The assigned NPI number for this provider is 1780875203 and is registered as an individual entity type.

The NPPES NPI record indicates the provider is a female.

The provider's business address is:

255 15TH ST
SUITE 103, BASEMENT LEVEL
BROOKLYN, NY
ZIP 11215-988
Phone: (718) 788-5101

The enumeration date for this NPI number is 8/8/2007 and was last updated on 7/13/2012.

Map - Location of Practice

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Taxonomy Codes

The following information regarding the scope of practice of this provider is available:

No. Taxonomy Code Taxonomy Clasification Taxonomy Specialization License Number License State Primary
1 104100000X Social Worker Yes

NPI Record

No. Field Name Field Value Field Definition 1
1 NPI 1780875203 The 10-position all-numeric identification number assigned by the NPS to uniquely identify a health care provider. The NPI number includes an ISO standard check-digit in the 10th position. There is no intelligence about the health care provider in the number.
2 Entity Type Code 1 Code describing the type of health care provider that is being assigned an NPI. Codes are 1 = (Person): individual human being who furnishes health care; 2 = (Non-person): entity other than an individual human being that furnishes health care (for example, hospital, SNF, hospital subunit, pharmacy, or HMO).
3 Provider Last Name Legal Name DAVIDOR The last name of the provider. If the provider is an individual, this is the legal name.
4 Provider First Name SHELLY The first name of the provider, if the provider is an individual.
5 Provider Name Prefix Text MS. The name prefix or salutation of the provider if the provider is an individual; for example, Mr., Mrs., or Corporal.
6 Provider Credential Text LCSW The abbreviations for professional degrees or credentials used or held by the provider, if the provider is an individual. Examples are MD, DDS, CSW, CNA, AA, NP, RNA, or PSY. These credential designations will not be verified by NPS.
7 Provider First Line Business Practice Location Address 255 15TH ST The first line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
8 Provider Second Line Business Practice Location Address SUITE 103, BASEMENT LEVEL The second line location address of the provider being identified. For providers with more than one physical location, this is the primary location. This address cannot include a Post Office box.
9 Provider Business Practice Location Address City Name BROOKLYN The city name in the location address of the provider being identified.
10 Provider Business Practice Location Address State Name NY The State code in the location of the provider being identified.
11 Provider Business Practice Location Address Postal Code 112154988 The postal ZIP or zone code in the location address of the provider being identified. NOTE: ZIP code plus 4-digit extension, if available.
12 Provider Business Practice Location Address Country Code If outside U S US The country code in the location address of the provider being identified.
13 Provider Business Practice Location Address Telephone Number 7187885101 The telephone number associated with the location address of the provider being identified.
14 Provider Enumeration Date 8/8/2007 The date the provider was assigned a unique identifier (assigned an NPI).
15 Last Update Date 7/13/2012 The date that a record was last updated or changed.
16 Provider Gender Code F The code designating the provider’s gender if the provider is a person.
17 Healthcare Provider Taxonomy Code 1 104100000X Code designating the provider type, classification, and specialization. Codes are from the Healthcare Provider Taxonomy code list. The NPS will associate these data with the license data for providers with Entity type code = 1.
18 Healthcare Provider Primary Taxonomy Switch 1 Y
19 Is Sole Proprietor N Code indicating whether the provider is operating as a sole proprietor. Codes are: Y = Yes; N = No

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This page was last updated on: 3/10/2015

(1) Field Definition Source-. Federal Register / Vol. 69, No. 15 / Friday, January 23, 2004 / Rules and Regulations - Part II Department of Health and Human Services Office of the Secretary 45 CFR Part 162 HIPAA Administrative Simplification: Standard Unique Health Identifier for Health Care Providers; Final Rule

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