Active NPI
Marie Miceli, LCSW
- Clinical Social Worker
- Elmont, NY
National Provider Identifier
1023189537
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 070389-1
- Practice address
- 570 Elmont Rd
Elmont, NY 11003-3535 - Phone
- (516) 437-6050
- NPI assigned
- Nov 13, 2006
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 070389-1 | NY | Primary |
Addresses
Primary practice location
570 Elmont Rd
Elmont, NY 11003-3535
Mailing address
570 Elmont Rd
Elmont, NY 11003-3535
Phone (516) 437-6050
Other identifiers 1
| Identifier | Type | State | Issuer |
|---|---|---|---|
| 01666971 | Medicaid | NY |
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 070389-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1163376000000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1203033600000",
"number": "1023189537",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "570 ELMONT RD",
"city": "ELMONT",
"state": "NY",
"postal_code": "110033535",
"telephone_number": "516-437-6050"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "570 ELMONT RD",
"city": "ELMONT",
"state": "NY",
"postal_code": "110033535",
"telephone_number": "516-437-6050"
}
],
"practiceLocations": [],
"basic": {
"last_name": "MICELI",
"first_name": "MARIE",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2006-11-13",
"last_updated": "2008-02-15",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "070389-1",
"primary": true
}
],
"identifiers": [
{
"code": "05",
"desc": "MEDICAID",
"issuer": null,
"identifier": "01666971",
"state": "NY"
}
],
"endpoints": [],
"other_names": []
}Other providers in Elmont, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 15, 2008; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.