Individual provider Active NPI

Melissa Avildsen, LCSW

  • Clinical Social Worker
  • White Plains, NY
National Provider Identifier
1265565543
Registry record updated Mar 24, 2009
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
RO44138-1 Issued in NY
Practice address
171 E Post Rd
White Plains, NY 10601-4965
Phone
(914) 993-9088
NPI assigned
Mar 14, 2007
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Mar 24, 2009

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X RO44138-1 NY Primary

Addresses

Primary practice location

171 E Post Rd
White Plains, NY 10601-4965

Mailing address

720 Fort Washington Ave
Apt. 2J
New York, NY 10040-3708
Phone (212) 568-3450

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
Eligible to order & refer
  • Part B services: Yes
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

Enrollment records 1

Enrollment IDStateProvider typePAC IDDetails
I20060201000852 NY Practitioner - Clinical Social Worker 5597779264 Practice locations: New York, NY

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 1990
Medicare assignment
Accepts the Medicare-approved amount as payment in full

Practice addresses (Care Compare)

15 W 84TH St
New York, NY 10024-4703
Phone (212) 568-3450

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
RO44138-1NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1173830400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1237852800000",
    "number": "1265565543",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "720 FORT WASHINGTON AVE",
            "address_2": "APT. 2J",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100403708",
            "telephone_number": "212-568-3450"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "171 E POST RD",
            "city": "WHITE PLAINS",
            "state": "NY",
            "postal_code": "106014965",
            "telephone_number": "914-993-9088"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "AVILDSEN",
        "first_name": "MELISSA",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2007-03-14",
        "last_updated": "2009-03-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "RO44138-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in White Plains, NY

Sources for this page

Verify at the official NPI Registry.