Individual provider Active NPI

Michelle Dawson, LCSW

  • Clinical Social Worker
  • Goshen, NY
National Provider Identifier
1306240536
Registry record updated May 15, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
093754 Issued in NY
Practice address
25 Golden Hill Ave
Goshen, NY 10924-1703
Phone
(845) 551-2628
NPI assigned
Oct 17, 2014
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 15, 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 093355 NY
Clinical Social Worker 1041C0700X 093754 NY Primary

Addresses

Primary practice location

25 Golden Hill Ave
Goshen, NY 10924-1703

Mailing address

25 Golden Hill Ave
Goshen, NY 10924-1703

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
I20220816002431 NY Practitioner - Clinical Social Worker 4082097571 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Other, 2014
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Group practices
Valera Medical PCGroup PAC ID 0547690521, 160 clinicians

Practice addresses (Care Compare)

134 N 4TH St
Brooklyn, NY 11249-3296
Phone (646) 450-7748

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
093355NYMDSocial Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Valera Medical, P.C. Social Worker CurrentSince Jul 1, 2022 Accepting new patients

Locations

134 N 4th St
Brooklyn, NY 11249

139 Centre St
Ste 824
New York, NY 10013
Phone (646) 450-7751

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1413504000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1715731200000",
    "number": "1306240536",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "25 GOLDEN HILL AVE",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109241703"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "25 GOLDEN HILL AVE",
            "city": "GOSHEN",
            "state": "NY",
            "postal_code": "109241703",
            "telephone_number": "845-551-2628"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "DAWSON",
        "first_name": "MICHELLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2014-10-17",
        "last_updated": "2024-05-15",
        "certification_date": "2024-05-15",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "093355",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "093754",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Goshen, NY

Sources for this page

Verify at the official NPI Registry.