Shabieko Shannon Ivy
Social Worker, Clinical in Brooklyn, NY. Individual provider (NPI-1).
NPI number1639830003
StatusActive
Last updated in NPPESJan 6, 2022
Details
- NPI
- 1639830003
- Entity type
- Individual (NPI-1)
- Name
- Shabieko Shannon Ivy
- Sex
- Female
- Sole proprietor
- No
- Enumeration date
- Jan 6, 2022
- Certification date
- Jan 6, 2022
- Last updated
- Jan 6, 2022
Taxonomy and licenses
| Taxonomy code | Description | License | State | Primary |
|---|---|---|---|---|
| 1041C0700X | Social Worker, Clinical | P113453 | NY | Yes |
Practice location
493 Nostrand Ave Ste 3Brooklyn, NY 11216-5118
Phone 718-230-1379
Mailing address
493 Nostrand Ave Ste 3Brooklyn, NY 11216-5118
Phone 718-230-1379
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