Active NPI
Michelle Ann Maddalozzo, DSW, LCSW
- Clinical Social Worker
- Hampton, VA
National Provider Identifier
1306141981
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 149.014331
- Practice address
- 77 Nealy Ave
Hampton, VA 23665-2040 - Phone
- (757) 298-5657
- NPI assigned
- Jan 13, 2011
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 2
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | |||
| Clinical Social Worker | 1041C0700X | 149.014331 | IL | Primary |
Addresses
Primary practice location
77 Nealy Ave
Hampton, VA 23665-2040
Mailing address
77 Nealy Ave
Hampton, VA 23665-2040
Other practice location 1
18th Medical Group
Unit 5142
Apo, AP 96367-9998
Phone (080) 634-0217
Electronic endpoints 1
| Type | Endpoint | Use | Affiliation |
|---|---|---|---|
| CONNECT URL | none | Other |
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
| License | State | Type | Specialty |
|---|---|---|---|
| 149.014331 | IL | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1294876800000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1656028800000",
"number": "1306141981",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "77 NEALY AVE",
"city": "HAMPTON",
"state": "VA",
"postal_code": "236652040"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "77 NEALY AVE",
"city": "HAMPTON",
"state": "VA",
"postal_code": "236652040",
"telephone_number": "757-298-5657"
}
],
"practiceLocations": [
{
"address_1": "18th Medical Group",
"address_2": "Unit 5142",
"address_purpose": "LOCATION",
"city": "APO",
"state": "AP",
"postal_code": "963679998",
"country_code": "US",
"telephone_number": "080-634-0217",
"country_name": "United States",
"address_type": "MIL"
}
],
"basic": {
"last_name": "MADDALOZZO",
"first_name": "MICHELLE",
"middle_name": "ANN",
"credential": "DSW, LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2011-01-13",
"last_updated": "2022-06-24",
"certification_date": "2022-06-24",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": null,
"license": null,
"primary": false
},
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "IL",
"license": "149.014331",
"primary": true
}
],
"identifiers": [],
"endpoints": [
{
"endpointType": "CONNECT",
"endpointTypeDescription": "CONNECT URL",
"endpoint": "none",
"affiliation": "N",
"endpointDescription": "none",
"use": "OTHER",
"useDescription": "Other",
"useOtherDescription": "none",
"contentType": "OTHER",
"contentTypeDescription": "Other",
"contentOtherDescription": "none",
"address_1": "77 Nealy Ave",
"city": "Hampton",
"state": "VA",
"country_code": "US",
"postal_code": "236652040",
"country_name": "United States",
"address_type": "DOM"
}
],
"other_names": []
}Other providers in Hampton, VA
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 24, 2022; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.