Individual provider Active NPI

Danielle M Mizrahi, LCSW

  • Clinical Social Worker
  • Douglaston, NY
National Provider Identifier
1508179862
Registry record updated Jul 18, 2016
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
081574 Issued in NY
Practice address
24302 Northern Blvd
Douglaston, NY 11362-1150
Phone
(718) 423-6200
NPI assigned
Jul 15, 2010
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Jul 18, 2016

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 081574 NY Primary

Addresses

Primary practice location

24302 Northern Blvd
Douglaston, NY 11362-1150

Mailing address

638 Western Park Dr
West Hempstead, NY 11552-2845
Phone (516) 220-9705

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
081574NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1279152000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1468800000000",
    "number": "1508179862",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "638 WESTERN PARK DR",
            "city": "WEST HEMPSTEAD",
            "state": "NY",
            "postal_code": "115522845",
            "telephone_number": "516-220-9705"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "24302 NORTHERN BLVD",
            "city": "DOUGLASTON",
            "state": "NY",
            "postal_code": "113621150",
            "telephone_number": "718-423-6200"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZRAHI",
        "first_name": "DANIELLE",
        "middle_name": "M",
        "name_prefix": "Ms.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-07-15",
        "last_updated": "2016-07-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "081574",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Douglaston, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 18, 2016; 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.