Individual provider Active NPI

Michelle Marie Kwiec, LCSW

  • Clinical Social Worker
  • Carbondale, PA
National Provider Identifier
1477064640
Registry record updated Aug 16, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
CW016936 Issued in PA
Practice address
35 Linda LN
Carbondale, PA 18407-1424
Phone
(570) 280-5431
NPI assigned
Oct 16, 2017
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Aug 16, 2024

Registry information is reported by the provider to CMS and is not verified. About this source

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X CW16936 PA
Clinical Social Worker 1041C0700X CW016936 PA Primary

Addresses

Primary practice location

35 Linda LN
Carbondale, PA 18407-1424

Mailing address

35 Linda LN
Carbondale, PA 18407-1424
Phone (570) 280-5431

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
CW016936PAMDClinical Social Worker
CW16936PAMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1508112000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1723766400000",
    "number": "1477064640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "35 LINDA LN",
            "city": "CARBONDALE",
            "state": "PA",
            "postal_code": "184071424",
            "telephone_number": "570-280-5431"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "35 LINDA LN",
            "city": "CARBONDALE",
            "state": "PA",
            "postal_code": "184071424",
            "telephone_number": "570-280-5431"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "KWIEC",
        "first_name": "MICHELLE",
        "middle_name": "MARIE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2017-10-16",
        "last_updated": "2024-08-16",
        "certification_date": "2024-08-16",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW16936",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "PA",
            "license": "CW016936",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Carbondale, PA

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Aug 16, 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.

Verify at the official NPI Registry.