DR. SHANE SHACKFORD (NPI# 1134405533) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1134405533 |
| Entity Type | Individual |
| Full Name | DR. SHANE SHACKFORD |
| Credential | PSY.D |
| Practice Address |
325 E Jimmie Leeds Rd Suite 182 Galloway NJ 08205-4126 |
| Practice Telephone | 6093258775 |
| Mailing Telephone | 6093258775 |
| Enumeration Date | 2011-10-29 |
| Last Update Date | 2011-10-29 |
| Gender Code | M |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TS0200X |
Psychologist Specialization: School |
2516 | NJ | Behavioral Health & Social Service Providers |
| Street Address |
325 E JIMMIE LEEDS RD SUITE 182 |
| City | GALLOWAY |
| State | NJ |
| Zip Code | 08205-4126 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1942834973 | Foot & Ankle Center of Sj | Podiatrist | 408 Chris Gaupp Dr Ste 300, Galloway, NJ 08205 | 2020-02-28 |
| 1922640747 | Eve Atwell | Physical Therapist | 323 S. Pitney Rd, Galloway, NJ 08205 | 2019-10-14 |
| 1558911560 | Marcelo Pantaleon Alfaro Jr. | Non-emergency Medical Transport (VAN) | 403 Ebony Tree Ave., Galloway, NJ 08205 | 2019-09-12 |
| 1194374504 | Marsha J Brown | Technician | 27 Brampton St, Galloway, NJ 08205 | 2019-09-09 |
| 1790246296 | Jennifer Cella-roe | Social Worker | 309 S New York Rd Ste 10, Galloway, NJ 08205 | 2019-03-27 |
| 1952881450 | Center for Family Services, Inc. | Community/Behavioral Health | 312 East White Horse Pike, Absecon, NJ 08205 | 2018-08-15 |
| 1780178707 | Atlantic Community Charter School | Case Management | 112 South New York Rd, Galloway, NJ 08205 | 2018-06-22 |
| 1467985952 | Brian Pauling | Chiropractor | 506 S. New York Rd., Galloway, NJ 08205 | 2017-04-11 |
| 1598118903 | Career Opportunity Development, Inc. | Community Based Residential Treatment, Mental Retardation and/or Developmental Disabilities | 106 Jim Leeds Road, Galloway, NJ 08205 | 2016-07-20 |
| 1033582085 | Caringhouse Projects, Inc | Respite Care | 506 2nd Avenue, Galloway, NJ 08205 | 2015-11-12 |
| Find all providers in zip 08205 | ||||
| Taxonomy Code | 103TS0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | School |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1174902688 | Sheila Kay Overmyer Core | Psychologist | 638 Aldengate Dr, Galloway, OH 43119-8638 | 2015-05-29 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1841802949 | Bianca De Jesus Diaz | Psychologist | 130 Hardenburgh Ave, Demarest, NJ 07627-2159 | 2020-08-19 |
| 1225648645 | Jennifer T. Mascolo | Psychologist | 18 Kings Hwy Ste 109, Middletown, NJ 07748-2509 | 2020-08-01 |
| 1912527425 | Corrine R. Mccarthy | Psychologist | 89 French St Rm 2225, New Brunswick, NJ 08901-1935 | 2020-04-24 |
| 1437782596 | Allison Paige Hawkins | Psychologist | 127 2nd St, Keyport, NJ 07735-1809 | 2020-02-18 |
| 1831729904 | Idler Educational Testing Services LLC | Psychologist | 109 Mimosa Dr, Sewell, NJ 08080-2804 | 2020-01-17 |
| 1588208193 | Daniel Cherry | Psychologist | 658 Valley Rd Apt 1e, Montclair, NJ 07043-1450 | 2019-11-06 |
| 1649812066 | Ana A Del Rosario | Psychologist | 7 Ambler Rd, Cherry Hill, NJ 08002-1303 | 2019-10-17 |
| 1558828590 | Michael Mosher | Psychologist | 72 Unger Ave, Stanhope, NJ 07874-2209 | 2019-02-26 |
| 1255819793 | Jamel Gibbs | Psychologist | 300 Durham Ave, Metuchen, NJ 08840-1712 | 2018-08-06 |
| 1235651019 | Ava Caroline Lorenzo | Psychologist | 115 Provincetown Ct, Flemington, NJ 08822-2023 | 2017-07-12 |
| Find all providers with the same taxonomy | ||||
Please comment or provide details below to improve the information on DR. SHANE SHACKFORD.
| Data Provider | Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES) |
| Jurisdiction | Medicare & Medicaid |
This dataset includes 5.44 million covered health care providers and all health plans and health care clearinghouses, registered with CMA NPPES. Each provider is registered with National Provider Identifier (NPI), full name, status, address, taxonomy, other identifiers, etc.