Individual provider Active NPI

Courtney Leigh Minelli, LMSW

  • Social Worker
  • Shirley, NY
National Provider Identifier
1043008550
Registry record updated Apr 26, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Social WorkerTaxonomy code 104100000X
License
126718 Issued in NY
Practice address
64 Chanel Dr E
Shirley, NY 11967-3810
Phone
(631) 275-7548
NPI assigned
Apr 26, 2025
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 26, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 126718 NY Primary

Addresses

Primary practice location

64 Chanel Dr E
Shirley, NY 11967-3810

Mailing address

64 Chanel Dr E
Shirley, NY 11967-3810
Phone (631) 275-7548

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
Green means eligible to order or refer.

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2024
Medicare assignment
May accept Medicare assignment

Practice addresses (Care Compare)

790 Park Ave
Huntington, NY 11743-4516

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
126718NYMDSocial Worker

NPI Registry JSON

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

{
    "created_epoch": "1745625600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1745625600000",
    "number": "1043008550",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "64 CHANEL DR E",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119673810",
            "telephone_number": "631-275-7548"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "64 CHANEL DR E",
            "city": "SHIRLEY",
            "state": "NY",
            "postal_code": "119673810",
            "telephone_number": "631-275-7548"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MINELLI",
        "first_name": "COURTNEY",
        "middle_name": "LEIGH",
        "name_prefix": "Mrs.",
        "credential": "LMSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2025-04-26",
        "last_updated": "2025-04-26",
        "certification_date": "2025-04-26",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "126718",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Shirley, NY

Sources for this page

Verify at the official NPI Registry.