Dennis Mikkelsen, L.C.S.W.

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

44SC04809100 Issued in NJ

Practice address

601 Broadway
Bayonne, NJ 07002-3818

Phone

(201) 339-9200

NPI assigned

Jan 17, 2007

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1168992000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1321401600000",
    "number": "1154473213",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "38 ROLLING HILL RD",
            "city": "CLINTON",
            "state": "NJ",
            "postal_code": "088092617",
            "telephone_number": "201-725-8022"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "601 BROADWAY",
            "city": "BAYONNE",
            "state": "NJ",
            "postal_code": "070023818",
            "telephone_number": "201-339-9200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIKKELSEN",
        "first_name": "DENNIS",
        "name_prefix": "Mr.",
        "credential": "L.C.S.W.",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2007-01-17",
        "last_updated": "2011-11-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SC04809100",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0021806",
            "state": "NJ"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Jonathan Tadros Michael, DPM
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• Midtown Pediatrics
• Midtown Pharmacy
• Marina Mikhail, FNP
• Michael Milad
• Ronald Kenneth Milan, M.D.
• Jonathan T Mingoia, FNP-C, D.C.
• Vanessa Marie Miranda
• Mohammed Waquas Mirza, MD

• Clinical Social Worker in Bayonne, NJ
• Providers in Bayonne, NJ by specialty
• Clinical Social Worker in New Jersey

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Nov 16, 2011; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.