Charles Miceli, MSW, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW5546 Issued in FL

Practice address

465 Summerhaven Dr
Suite 1-a
Debary, FL 32713-5211

Phone

(407) 493-8181

Fax

(407) 788-3075

NPI assigned

Jun 17, 2013

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

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

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

{
    "created_epoch": "1371427200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1371427200000",
    "number": "1174962799",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1405 HEARTHSTONE LN",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327503343",
            "telephone_number": "407-493-8181",
            "fax_number": "407-788-3075"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "465 SUMMERHAVEN DR",
            "address_2": "SUITE 1-A",
            "city": "DEBARY",
            "state": "FL",
            "postal_code": "327135211",
            "telephone_number": "407-493-8181",
            "fax_number": "407-788-3075"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICELI",
        "first_name": "CHARLES",
        "name_prefix": "Mr.",
        "credential": "MSW, LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2013-06-17",
        "last_updated": "2013-06-17",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW5546",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Mid Florida Urgent Care LLC
• Craig Louis Miller, RBT
• Teresa Miller, LMT
• Anita Misra Goulart, DPM
• Monarch Life Skills & Play Center

• Clinical Social Worker in Debary, FL
• Providers in Debary, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 17, 2013; 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.