Keri Mica LCSW PC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

KERI MICA LCSW PC

Practice address

176 N Village Ave
Suite 2E
Rockville Centre, NY 11570-3800

Phone

(516) 410-7138

Fax

(516) 679-0736

NPI assigned

Aug 8, 2007

Last updated

Aug 8, 2007By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Ms. Keri Lynn Mica-Suttmiller, LCSW-RNPI 1689617490

Title

President

Phone

(516) 410-7138

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Locations

Practitioners 5

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Keri Mica-Suttmiller, LCSW

  • Clinical Social Worker
  • Rockville Centre, NY
  • NPI 1689617490
  Medicare reassignment NPD Authorized official
• Matthew Alan Krivoshey, PSY.D.

  • Clinical Psychologist
  • Huntington, NY
  • NPI 1295733699
  NPD (past)
• Stuart Wasser, MD

  • Internal Medicine Physician
  • Rockville Centre, NY
  • NPI 1922099852
  NPD (past)
• Steve Osani, PA-C, FAAPA

  • Medical Physician Assistant
  • Santa Maria, CA
  • NPI 1124286893
  NPD (past)
• Irene Ross, LCSW

  • Clinical Social Worker
  • Hallandale Beach, FL
  • NPI 1962565341
  NPD (past)

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

{
    "created_epoch": "1186531200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1186531200000",
    "number": "1053502518",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 HART STREET",
            "city": "LYNBROOK",
            "state": "NY",
            "postal_code": "115631760",
            "telephone_number": "516-410-7138",
            "fax_number": "516-679-0736"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "176 N VILLAGE AVE",
            "address_2": "SUITE 2E",
            "city": "ROCKVILLE CENTRE",
            "state": "NY",
            "postal_code": "115703800",
            "telephone_number": "516-410-7138",
            "fax_number": "516-679-0736"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "KERI MICA LCSW PC",
        "organizational_subpart": "NO",
        "enumeration_date": "2007-08-08",
        "last_updated": "2007-08-08",
        "status": "A",
        "authorized_official_last_name": "MICA-SUTTMILLER",
        "authorized_official_first_name": "KERI",
        "authorized_official_middle_name": "LYNN",
        "authorized_official_title_or_position": "PRESIDENT",
        "authorized_official_telephone_number": "516-410-7138",
        "authorized_official_name_prefix": "Ms.",
        "authorized_official_credential": "LCSW-R"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "02735202",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Maura Renee Kelly-Magliaro, OTR/L
• Janice Kelly, CSW
• Mary A Kelly, NP-C
• Samantha A. Kelly, CRNA
• Heidi Lee Kenny
• Jay A Kerner, DPM
• Howard N. Kessler, D.P.M.
• Leonard Kessler, MD
• Mark A Kessler, M.D.
• Laura B Kestemberg, PH.D.

• Clinical Social Worker in Rockville Centre, NY
• Providers in Rockville Centre, 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 Aug 8, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.