Active NPI
Michelle Alicia Phillips, LCSW
- Mental Health Counselor
- Brooklyn, NY
National Provider Identifier
1033961099
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Mental Health Counselor
- License
- 095018
- Practice address
- 5621 Tilden Ave
Brooklyn, NY 11203-4819 - Phone
- (646) 270-6699
- NPI assigned
- Apr 3, 2024
- 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 |
|---|---|---|---|---|
| Mental Health Counselor | 101YM0800X | 095018 | NY | Primary |
Addresses
Primary practice location
5621 Tilden Ave
Brooklyn, NY 11203-4819
Mailing address
5621 Tilden Ave
Brooklyn, NY 11203-4819
Phone (646) 270-6699
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
- Eligible to order & refer
- Part B services: No
- Medical equipment: Yes
- Home health: No
- Power mobility devices: No
- Hospice: No
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Enrolled
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1712102400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1712102400000",
"number": "1033961099",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "5621 TILDEN AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112034819",
"telephone_number": "646-270-6699"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "5621 TILDEN AVE",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "112034819",
"telephone_number": "646-270-6699"
}
],
"practiceLocations": [],
"basic": {
"last_name": "PHILLIPS",
"first_name": "MICHELLE",
"middle_name": "ALICIA",
"name_prefix": "Ms.",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2024-04-03",
"last_updated": "2024-04-03",
"certification_date": "2024-03-25",
"status": "A"
},
"taxonomies": [
{
"code": "101YM0800X",
"taxonomy_group": "",
"desc": "Counselor, Mental Health",
"state": "NY",
"license": "095018",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 3, 2024; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.