Provider Demographics
NPI:1477351799
Name:SHINSATO, LILLIAN (LCSW)
Entity type:Individual
Prefix:
First Name:LILLIAN
Middle Name:
Last Name:SHINSATO
Suffix:
Gender:
Credentials:LCSW
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20828 15TH DR FL 2
Mailing Address - Street 2:
Mailing Address - City:BAYSIDE
Mailing Address - State:NY
Mailing Address - Zip Code:11360-1135
Mailing Address - Country:US
Mailing Address - Phone:347-804-1061
Mailing Address - Fax:
Practice Address - Street 1:20828 15TH DR FL 2
Practice Address - Street 2:
Practice Address - City:BAYSIDE
Practice Address - State:NY
Practice Address - Zip Code:11360-1135
Practice Address - Country:US
Practice Address - Phone:347-804-1061
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-03-04
Last Update Date:2025-03-04
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR050226-011041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical