Mark Miceli, MSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW19414 Issued in FL

Practice address

455 W Warren Ave
Longwood, FL 32750-4038

Phone

(407) 262-2220

Fax

(407) 834-5011

NPI assigned

Jan 19, 2022

Sex

Male

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in FL

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

Medicare enrollment (NPD)

Enrolled

State licenses

Practice roles

Locations

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.

• Orlando Health Medical Group Inc

  • Internal Medicine Physician
  • Orlando, FL
  • NPI 1669429577

  FL

  Medicare reassignment NPD
• Horizon West Counseling, PLLC

  • Mental Health Clinic/Center (Including Community Mental Health Center)
  • Winter Garden, FL
  • NPI 1417693664
  NPD Authorized official
• Grow Healthcare Group PA

  • Mental Health Counselor
  • Miami, FL
  • NPI 1245845932

  FL

  Medicare reassignment
• Orlando Health Medical Group Inc

  • Durable Medical Equipment & Medical Supplies
  • Winter Park, FL
  • NPI 1265019541
  NPD

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

{
    "created_epoch": "1642550400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1681171200000",
    "number": "1487306643",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "455 W WARREN AVE",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504038",
            "telephone_number": "407-262-2220",
            "fax_number": "407-834-5011"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "455 W WARREN AVE",
            "city": "LONGWOOD",
            "state": "FL",
            "postal_code": "327504038",
            "telephone_number": "407-262-2220",
            "fax_number": "407-834-5011"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "16830 Wingspread Loop",
            "address_purpose": "LOCATION",
            "city": "Winter Garden",
            "state": "FL",
            "postal_code": "347879550",
            "country_code": "US",
            "telephone_number": "617-388-6912",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "MICELI",
        "first_name": "MARK",
        "name_prefix": "Dr.",
        "credential": "MSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2022-01-19",
        "last_updated": "2023-04-11",
        "certification_date": "2023-04-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW19414",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Katharine W. Mendoza, MSW, LCSW
• Rosanell Merced, DC
• Mercy Road Christian Counseling Centers, LLC
• Morgan Meredith, LMHC
• MF Longwood LLC
• Michael E. Hempfield, DC, Fiama, LLC
• Michelle Butler
• Mid Florida Adult Medicine LLC
• Ashley Brooke Midkiff, LCSW
• Linda Carol Milam, RN

• All providers in Longwood, FL
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Apr 11, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.