Individual provider Active NPI

Michael Neustadt, LICSW

  • Mental Health Counselor
  • Washington, DC
National Provider Identifier
1043721400
Registry record updated Oct 12, 2017
On this page

Key facts

NPPES NPI Registry
Primary specialty
Mental Health CounselorTaxonomy code 101YM0800X
License
LC50081448 Issued in DC
Practice address
4201 Connecticut Ave NW Ste 300
Washington, DC 20008-1162
Phone
(202) 610-0066
NPI assigned
Oct 12, 2017
Last updated
Oct 12, 2017By the provider in NPPES
Sex
Male
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Oct 12, 2017

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Mental Health Counselor 101YM0800X LC50081448 DC Primary

Addresses

Primary practice location

4201 Connecticut Ave NW Ste 300
Washington, DC 20008-1162

Mailing address

6509 4TH Ave
Takoma Park, MD 20912-4843
Phone (240) 246-5786

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in DC
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20180117000617 DC Practitioner - Clinical Social Worker 5294094439 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
LC50081448DCMDMental Health Counselor

Organizations & group practices 1

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.

NPI Registry JSON

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

{
    "created_epoch": "1507766400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1507766400000",
    "number": "1043721400",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6509 4TH AVE",
            "city": "TAKOMA PARK",
            "state": "MD",
            "postal_code": "209124843",
            "telephone_number": "240-246-5786"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "4201 CONNECTICUT AVE NW STE 300",
            "city": "WASHINGTON",
            "state": "DC",
            "postal_code": "200081162",
            "telephone_number": "202-610-0066"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NEUSTADT",
        "first_name": "MICHAEL",
        "credential": "LICSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-10-12",
        "last_updated": "2017-10-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101YM0800X",
            "taxonomy_group": "",
            "desc": "Counselor, Mental Health",
            "state": "DC",
            "license": "LC50081448",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Washington, DC

Sources for this page

Verify at the official NPI Registry.