Provider Demographics
NPI:1932077062
Name:ESPOSITO, SHAYNE (MSW, RCSWI)
Entity type:Individual
Prefix:
First Name:SHAYNE
Middle Name:
Last Name:ESPOSITO
Suffix:
Gender:F
Credentials:MSW, RCSWI
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:265 LAGO CIR APT 307
Mailing Address - Street 2:
Mailing Address - City:MELBOURNE
Mailing Address - State:FL
Mailing Address - Zip Code:32904-3387
Mailing Address - Country:US
Mailing Address - Phone:845-750-9654
Mailing Address - Fax:
Practice Address - Street 1:56 E PINE ST
Practice Address - Street 2:
Practice Address - City:ORLANDO
Practice Address - State:FL
Practice Address - Zip Code:32801-2618
Practice Address - Country:US
Practice Address - Phone:845-750-9654
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-10-29
Last Update Date:2025-10-29
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
FLISW20709101YA0400X
Provider Taxonomies
Primary?CodeTypeClassificationSpecializationGroup
Yes101YA0400XBehavioral Health & Social Service ProvidersCounselorAddiction (Substance Use Disorder)Group - Multi-Specialty