Provider Demographics
NPI:1316052731
Name:SHINGALA, YOGESH M (LCSWR)
Entity type:Individual
Prefix:
First Name:YOGESH
Middle Name:M
Last Name:SHINGALA
Suffix:
Gender:M
Credentials:LCSWR
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:20 DAVIS AVENUE
Mailing Address - Street 2:
Mailing Address - City:POUGHKEEPSIE
Mailing Address - State:NY
Mailing Address - Zip Code:12603-2408
Mailing Address - Country:US
Mailing Address - Phone:845-485-3500
Mailing Address - Fax:845-485-8780
Practice Address - Street 1:510 HAIGHT AVENUE
Practice Address - Street 2:SUITE 203 SPECTRUM BEHAVIORAL MANAGEMENT SERV INC
Practice Address - City:POUGHKEEPSIE
Practice Address - State:NY
Practice Address - Zip Code:12603-2408
Practice Address - Country:US
Practice Address - Phone:845-485-3500
Practice Address - Fax:845-485-8780
Is Sole Proprietor?:No
Enumeration Date:2006-08-19
Last Update Date:2007-07-08
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NYR0440211041C0700X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes1041C0700XBehavioral Health & Social Service ProvidersSocial WorkerClinical
Provider Identifiers
StateIdentifier IDID TypeIssuer
526481OtherVALUE OPTIONS
1033150OtherBEACON HEALTH STRAT
7348287OtherVALUE OPTIONS
782975OtherMVP HEALTH CARE
NYN800C1Medicare ID - Type Unspecified
526481OtherVALUE OPTIONS