Provider Demographics
NPI:1598558355
Name:LINDO, JAMILAH SHANICE (PSYD)
Entity type:Individual
Prefix:DR
First Name:JAMILAH
Middle Name:SHANICE
Last Name:LINDO
Suffix:
Gender:F
Credentials:PSYD
Other - Prefix:
Other - First Name:
Other - Middle Name:
Other - Last Name:
Other - Suffix:
Other - Last Name Type:
Other - Credentials:
Mailing Address - Street 1:34 JOHNSON ST
Mailing Address - Street 2:
Mailing Address - City:AMITYVILLE
Mailing Address - State:NY
Mailing Address - Zip Code:11701-1515
Mailing Address - Country:US
Mailing Address - Phone:516-972-0072
Mailing Address - Fax:
Practice Address - Street 1:114 5TH AVE FL 2
Practice Address - Street 2:
Practice Address - City:NEW YORK
Practice Address - State:NY
Practice Address - Zip Code:10011-5611
Practice Address - Country:US
Practice Address - Phone:516-972-0072
Practice Address - Fax:
Is Sole Proprietor?:Yes
Enumeration Date:2025-05-26
Last Update Date:2025-05-26
Deactivation Date:
Deactivation Code:
Reactivation Date:
Provider Licenses
StateLicense IDTaxonomies
NY027253103T00000X
Provider Taxonomies
Primary?CodeTypeClassificationSpecialization
Yes103T00000XBehavioral Health & Social Service ProvidersPsychologist