Alessandra Mikic, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

093812 Issued in NY

Practice address

220 5TH Ave FL 11
New York, NY 10001-8017

Phone

(609) 273-1391

NPI assigned

Nov 14, 2018

Last updated

Sep 23, 2022By the provider in NPPES

Sex

Female

Sole proprietor

Yes

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Opted out of Medicare

Yes, effective Mar 24, 2023 through Mar 24, 2027

Medicare enrollment (NPD)

Not enrolled

State licenses

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

• Dynamic Psychotherapy LCSW PLLC

  • Clinical Social Worker
  • New York, NY
  • NPI 1700561198
  Authorized official Same address or phone

The complete NPPES record for this NPI in the NPI Registry API format.

{
    "created_epoch": "1542153600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1663891200000",
    "number": "1023587573",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 5TH AVE FL 11",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100018017",
            "telephone_number": "609-273-1391"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 5TH AVE FL 11",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100018017",
            "telephone_number": "609-273-1391"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKIC",
        "first_name": "ALESSANDRA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2018-11-14",
        "last_updated": "2022-09-23",
        "certification_date": "2022-09-23",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "105371",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "093812",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katherine Claire Mikhailov, AUD
• Daniel Mikhaylov
• Daniela Mikhaylov, MD
• Margarita Mikhaylova, D.O
• Mark Mikhly, M.D.
• Sophia Mikityanskiy, D.O.
• Loganne Tatjana Mikkelsen, OD
• Eeva Johanna Mikkola, M.D.
• Evgeny Mikler, PA-C
• Benjamin Alexander Miko, MD

• Clinical Social Worker in New York, NY
• Providers in New York, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 23, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Opt Out Affidavits.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.