Active NPI
Michelle Heidami
- Counselor
- Brooklyn, NY
National Provider Identifier
1285456590
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Counselor
- License
- 014299
- Practice address
- 590 Flatbush Avenue
14 S
Brooklyn, NY 11225 - Phone
- (917) 722-2392
- NPI assigned
- Oct 28, 2024
- Last updated
- Oct 28, 2024
- Sex
- Female
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Counselor | 101Y00000X | 014299 | NY | Primary |
Addresses
Primary practice location
590 Flatbush Avenue
14 S
Brooklyn, NY 11225
Mailing address
900 West 190TH Street
6N
New York City, NY 10040
Phone (281) 744-1223
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
| License | State | Type | Specialty |
|---|---|---|---|
| 014299 | NY | MD | Speech-Language Pathologist |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Liberation-Based Therapy LCSW PLLC | Current | Accepting new patients |
Organizations & group practices 1
Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.
-
- Clinical Social Worker
- Brooklyn, NY
- NPI 1255926176
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1730073600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1730073600000",
"number": "1285456590",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "900 WEST 190TH STREET",
"address_2": "6N",
"city": "NEW YORK CITY",
"state": "NY",
"postal_code": "10040",
"telephone_number": "281-744-1223"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "590 FLATBUSH AVENUE",
"address_2": "14 S",
"city": "BROOKLYN",
"state": "NY",
"postal_code": "11225",
"telephone_number": "917-722-2392"
}
],
"practiceLocations": [],
"basic": {
"last_name": "HEIDAMI",
"first_name": "MICHELLE",
"sole_proprietor": "NO",
"sex": "F",
"enumeration_date": "2024-10-28",
"last_updated": "2024-10-28",
"certification_date": "2024-10-24",
"status": "A"
},
"taxonomies": [
{
"code": "101Y00000X",
"taxonomy_group": "",
"desc": "Counselor",
"state": "NY",
"license": "014299",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Brooklyn, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Oct 28, 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.