Individual provider Active NPI

Michaia Walker, LCSW

  • Clinical Social Worker
  • Jamaica, NY
National Provider Identifier
1184010910
Registry record updated Dec 20, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
086021 Issued in NY
Practice address
11811 Sutphin Blvd
Jamaica, NY 11434-2061
Phone
(443) 841-5693
NPI assigned
Apr 8, 2015
Sex
Unspecified or another gender identity
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Dec 20, 2024

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 090151 NY
Clinical Social Worker 1041C0700X 086021 NY Primary

Addresses

Primary practice location

11811 Sutphin Blvd
Jamaica, NY 11434-2061

Mailing address

11811 Sutphin Blvd # 98146
Jamaica, NY 11434-2061
Phone (443) 841-5693

Other practice location 1

2901 Campus Rd
Brooklyn, NY 11210-2153
Phone (917) 971-9125

Other practice location 2

2901 Campus Rd
Brooklyn, NY 11210-2153
Phone (917) 971-9125

Other practice location 3

11811 Sutphin Blvd # 98146
Jamaica, NY 11434-2061
Phone (443) 841-5693

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Not enrolled

State licenses

LicenseStateTypeSpecialty
090151NYMDSocial Worker
086021NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1428451200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1734652800000",
    "number": "1184010910",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "11811 SUTPHIN BLVD # 98146",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114342061",
            "telephone_number": "443-841-5693"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "11811 SUTPHIN BLVD",
            "city": "JAMAICA",
            "state": "NY",
            "postal_code": "114342061",
            "telephone_number": "443-841-5693"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "2901 Campus Rd",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112102153",
            "country_code": "US",
            "telephone_number": "917-971-9125",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "2901 Campus Rd",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112102153",
            "country_code": "US",
            "telephone_number": "917-971-9125",
            "country_name": "United States",
            "address_type": "DOM"
        },
        {
            "address_1": "11811 Sutphin Blvd # 98146",
            "address_purpose": "LOCATION",
            "city": "Jamaica",
            "state": "NY",
            "postal_code": "114342061",
            "country_code": "US",
            "telephone_number": "443-841-5693",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "WALKER",
        "first_name": "MICHAIA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "X",
        "enumeration_date": "2015-04-08",
        "last_updated": "2024-12-20",
        "certification_date": "2024-12-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "090151",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "086021",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Jamaica, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 20, 2024; 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.