Individual provider Active NPI

Midge M Lunsford, M.S.W.

  • Clinical Social Worker
  • Bronx, NY
National Provider Identifier
1265594386
Registry record updated Jul 8, 2007
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
R029548-1 Issued in NY
Practice address
3919 Dyre Ave
Bronx, NY 10466-2507
Phone
(718) 974-6622
Fax
(718) 320-9203
NPI assigned
Dec 14, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 8, 2007

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 R029548-1 NY Primary

Addresses

Primary practice location

3919 Dyre Ave
Bronx, NY 10466-2507

Mailing address

3410 De Reimer Ave
Suite 7a
Bronx, NY 10475-1518
Phone (718) 320-9203

Other identifiers 3

IdentifierTypeStateIssuer
1056560OtherNYBEACON HEALTH STRATEGIES
163907OtherNYVALUEOPTIONS
7480145OtherNYGHI

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)
Enrolled

State licenses

LicenseStateTypeSpecialty
R029548-1NYMDClinical Social Worker
029548NYMDPharmacist

NPI Registry JSON

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

{
    "created_epoch": "1166054400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1265594386",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3410 DE REIMER AVE",
            "address_2": "SUITE 7A",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104751518",
            "telephone_number": "718-320-9203",
            "fax_number": "718-320-9203"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3919 DYRE AVE",
            "city": "BRONX",
            "state": "NY",
            "postal_code": "104662507",
            "telephone_number": "718-974-6622",
            "fax_number": "718-320-9203"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "LUNSFORD",
        "first_name": "MIDGE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "M.S.W.",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-12-14",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R029548-1",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "BEACON HEALTH STRATEGIES",
            "identifier": "1056560",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "VALUEOPTIONS",
            "identifier": "163907",
            "state": "NY"
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "GHI",
            "identifier": "7480145",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

Other providers in Bronx, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.