Michael Carmine Izzo, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

228175 Issued in MA

Practice address

175 Federal St Ste 1400
Boston, MA 02110-2237

Phone

(617) 336-3246

NPI assigned

Sep 7, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Electronic endpoints 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Mike Izzo Therapy LLC

  • Clinical Social Worker
  • Dorchester, MA
  • NPI 1730994658
  NPD Authorized official
• Collaborative Insight Counseling Associates, LLC

  • Counselor
  • Boston, MA
  • NPI 1760950943
  NPD

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

{
    "created_epoch": "1662508800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1662508800000",
    "number": "1174244222",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "175 FEDERAL ST STE 1400",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021102237",
            "telephone_number": "617-336-3246"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "175 FEDERAL ST STE 1400",
            "city": "BOSTON",
            "state": "MA",
            "postal_code": "021102237",
            "telephone_number": "617-336-3246"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IZZO",
        "first_name": "MICHAEL",
        "middle_name": "CARMINE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-09-07",
        "last_updated": "2022-09-07",
        "certification_date": "2022-09-07",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "MA",
            "license": "228175",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [
        {
            "endpointType": "OTHERS",
            "endpointTypeDescription": "Other URL",
            "endpoint": "https://secure.simplepractice.com/users/sign_in",
            "affiliation": "N",
            "address_1": "175 Federal St Ste 1400",
            "city": "Boston",
            "state": "MA",
            "country_code": "US",
            "postal_code": "021102237",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "other_names": []
}

• Hope Iyiewuare
• Azade Izadi, M.D.
• Aaron Izenberg, MD
• Mitchell Izower, BS, MD
• Louis Izzi
• Nicole Izzo, PA
• Victoria Izzo, LMHC
• Saef Izzy, M.D.
• J. Wallace McMeel, M.D., P.C.
• J.Edmond LLC

• Clinical Social Worker in Boston, MA
• Providers in Boston, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 7, 2022; 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.