Active NPI
Michelle Dixon
- Social Worker
- Bronx, NY
National Provider Identifier
1376000257
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 080876
- Practice address
- 860 Melrose Ave
Bronx, NY 10451-4443 - Phone
- (917) 473-6996
- NPI assigned
- Feb 27, 2019
- 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 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 080876 | NY | Primary |
Addresses
Primary practice location
860 Melrose Ave
Bronx, NY 10451-4443
Mailing address
2305 Grand Ave Apt 2G
Bronx, NY 10468-7038
Phone (845) 642-7414
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 |
|---|---|---|---|
| 080876 | NY | MD | Clinical Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Long Island Consultation Center | Current | Accepting new patients |
Locations
9131 Queens Blvd
Ste 222
Elmhurst, NY 11373
Phone (718) 896-3400
Interoperability endpoints
- https://api.qualifacts.org/api/fhir/liccnewyorkcity/r4/
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.
-
- Counselor
- Elmhurst, NY
- NPI 1356016703
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1551225600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1551225600000",
"number": "1376000257",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "2305 GRAND AVE APT 2G",
"city": "BRONX",
"state": "NY",
"postal_code": "104687038",
"telephone_number": "845-642-7414"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "860 MELROSE AVE",
"city": "BRONX",
"state": "NY",
"postal_code": "104514443",
"telephone_number": "917-473-6996"
}
],
"practiceLocations": [],
"basic": {
"last_name": "DIXON",
"first_name": "MICHELLE",
"name_prefix": "Ms.",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2019-02-27",
"last_updated": "2019-02-27",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "080876",
"primary": true
}
],
"identifiers": [],
"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 Feb 27, 2019; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.