Provider Demographics
NPI:1184242455
Name:SHOOT, FELICE KAREN (LMHC)
Entity type:Individual
Prefix:
First Name:FELICE
Middle Name:KAREN
Last Name:SHOOT
Suffix:
Gender:F
Credentials:LMHC
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:88 GREENWICH ST APT 1403
Mailing Address - Street 2:
Mailing Address - City:NEW YORK
Mailing Address - State:NY
Mailing Address - Zip Code:10006-2237
Mailing Address - Country:US
Mailing Address - Phone:914-548-0677
Mailing Address - Fax:
Practice Address - Street 1:88 GREENWICH ST APT 1403
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10006-2237
Practice Address - Country:US
Practice Address - Phone:914-548-0677
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2020-07-13
Last Update Date:2020-07-13
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY005538-1101YM0800X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes101YM0800XBehavioral Health & Social Service ProvidersCounselorMental Health
Provider Identifiers
StateIdentifier IDID TypeIssuer
NY005538-1OtherNEW YORK STATE