Michelle Nelson, LCSW

Primary specialty

Social WorkerTaxonomy code 104100000X

Practice address

3458 Neely Rd
MC Guire Afb, NJ 08641-5312

Phone

(609) 754-9448

NPI assigned

Nov 2, 2005

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

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.

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1130889600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1639526400000",
    "number": "1083605794",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3458 NEELY RD",
            "city": "MC GUIRE AFB",
            "state": "NJ",
            "postal_code": "086415312",
            "telephone_number": "609-754-9448"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3458 NEELY RD",
            "city": "MC GUIRE AFB",
            "state": "NJ",
            "postal_code": "086415312",
            "telephone_number": "609-754-9448"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "NELSON",
        "first_name": "MICHELLE",
        "name_prefix": "Mrs.",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2005-11-02",
        "last_updated": "2021-12-15",
        "certification_date": "2021-12-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC00214700",
            "primary": false
        },
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LCSW",
            "identifier": "44SC00214700",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jiheh Lee, PA-C
• Robert D Lefkowitz, DDS
• Munair Lewis-Francis
• Kyle Marrache, DO
• Stedman Mazyck
• Cynthia Rose Noll, DMD
• Adam Poller
• Brian Joseph Portanova, FNP-BC
• Preferred Health Solutions
• Nyasia Ivelisse Rivera, FNP

• Social Worker in MC Guire Afb, NJ
• Providers in MC Guire Afb, NJ by specialty
• Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 15, 2021; 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.

Verify at the official NPI Registry.