DR. JULISSA GARRIS-SHADE (NPI# 1740722313) is a health care provider registered in Centers for Medicare & Medicaid Services (CMS), National Plan and Provider Enumeration System (NPPES).
| Nation Provider ID (NPI) | 1740722313 |
| Entity Type | Individual |
| Full Name | DR. JULISSA GARRIS-SHADE |
| Credential | PSY.D. |
| Practice Address |
222 Bagatelle Rd Melville NY 11747-4104 |
| Practice Telephone | 6316436960 |
| Mailing Telephone | 6316436960 |
| Enumeration Date | 2016-11-13 |
| Last Update Date | 2016-11-13 |
| Gender Code | F |
| Is Sole Proprietor | Y |
| Primary | Taxonomy Code | Classification | License Number | License State | Taxonomy Group |
|---|---|---|---|---|---|
| Y | 103TS0200X |
Psychologist Specialization: School |
Behavioral Health & Social Service Providers |
| Street Address |
222 BAGATELLE RD |
| City | MELVILLE |
| State | NY |
| Zip Code | 11747-4104 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1891316139 | Shaina Flanzraich | Physical Therapist | 3237 1800 Walt Whitman Rd, 120, Melville, NY 11747 | 2020-04-28 |
| 1952943763 | Liana Danielle Maher | Behavior Technician | 225 Broadhallow Road Suite 402, Melville, NY 11747 | 2019-10-14 |
| 1114402096 | Anicka Inez Douglas | Behavior Technician | 225 Broadhollow Road Suite 402, Melville, NY 11747 | 2018-09-26 |
| 1962988717 | Brien Nina-louise Potter | Behavior Technician | 225 Broadhollow Road, Suite 402, Melville, NY 11747 | 2018-07-16 |
| 1750804951 | Iri: Innovative Resources for Independence | Intermediate Care Facility, Mentally Retarded | 922 Rainbow Commons Ct, Melville, NY 11747 | 2017-07-19 |
| 1386178127 | Marissa Zydor | Specialist | 538 Ny-110 #202, Melville, NY 11747 | 2017-04-19 |
| 1992236624 | Annmarie Irene Russo | Behavior Technician | 538 Ny-110, Suite 202, Melville, NY 11747 | 2017-03-24 |
| 1205378130 | Independent Group Home Living Program, Inc | Nursing Facility/Intermediate Care Facility | 914 Rainbow Commons, Melville, NY 11747 | 2016-11-09 |
| 1932641867 | Independent Group Home Living Program, Inc | Nursing Facility/Intermediate Care Facility | 917 Rainbow Commons, Melville, NY 11747 | 2016-11-09 |
| 1740732999 | Independent Group Home Living Program, Inc | Nursing Facility/Intermediate Care Facility | 924 Rainbow Commons, Melville, NY 11747 | 2016-11-03 |
| Find all providers in zip 11747 | ||||
| Taxonomy Code | 103TS0200X |
| Grouping | Behavioral Health & Social Service Providers |
| Classification | Psychologist |
| Specialization | School |
| Definition to come... |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1134617483 | Heather Natter | Psychologist | 11 Sorrel Hill Ct, Melville, NY 11747-4121 | 2018-04-23 |
| 1386054690 | Stacey St.john | Psychologist | 538 Brushhollow Road, Suite 202, Melville, NY 11747 | 2014-05-08 |
| 1952887887 | Raina Samantha Lewis | Psychologist | 225 Broadhollow Rd Ste 402, Melville, NY 11747-4899 | 2018-07-13 |
| 1346756970 | Lisa A Morris | Psychologist | 225 Broadhollow Rd Ste 402, Melville, NY 11747-4899 | 2017-12-19 |
| 1235688870 | Alyssa Perri | Psychologist | 538 Broadhollow Rd, Suite 202, Melville, NY 11747-3676 | 2016-09-23 |
| 1720435670 | Kimberly Ann Falkowski-pepe | Psychologist | 538 Broadhollow Rd, 202, Melville, NY 11747-3676 | 2016-05-20 |
| NPI | Name | Taxonomy | Address | Enumeration |
|---|---|---|---|---|
| 1548860612 | Zoe Spiegel | Psychologist | 20 Harding Dr, New Rochelle, NY 10801-4610 | 2020-10-28 |
| 1053910059 | Erin Elizabeth Gurdineer | Psychologist | 131 South Third St, Northville, NY 12134-0608 | 2020-10-21 |
| 1114534310 | Alana May Sandberg | Psychologist | 10421 68th Dr Apt A20, Forest Hills, NY 11375-3475 | 2020-09-30 |
| 1437766177 | Danielle Brudner | Psychologist | 18 Cygnet Rd, Congers, NY 10920-1790 | 2020-09-27 |
| 1023624145 | Karleen Marie Gabriel | Psychologist | 35 Steven Pl, Smithtown, NY 11787-5419 | 2020-09-23 |
| 1730795832 | Erin A Hyle | Psychologist | 9 Maywood Ave, Rye Brook, NY 10573-2401 | 2020-09-23 |
| 1083220826 | Tina Ruggiero | Psychologist | 61 Fox Ct, Manorville, NY 11949-2613 | 2020-09-17 |
| 1952917650 | Margaret Jane Willard | Psychologist | 167 15th St Apt 2l, Brooklyn, NY 11215-4849 | 2020-09-17 |
| 1902410137 | Dana Levine | Psychologist | 7 Chester Dr, Great Neck, NY 11021-4904 | 2020-09-04 |
| 1871107946 | Michele D Jefferson | Psychologist | 66 Main St Apt 525, Yonkers, NY 10701-8853 | 2020-09-04 |
| Find all providers with the same taxonomy | ||||
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| 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.