Individual provider Active NPI

Alessandra Miceli

  • Clinical Child & Adolescent Psychologist
  • Pelham, NY
National Provider Identifier
1518643105
Registry record updated Dec 10, 2025
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Child & Adolescent PsychologistTaxonomy code 103TC2200X
Practice address
629 Fifth Ave Ste 109
Pelham, NY 10803-3708
Phone
(914) 368-2995
NPI assigned
Jun 27, 2023
Last updated
Dec 10, 2025By the provider in NPPES
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 10, 2025

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

Specialties & licenses 1

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Child & Adolescent Psychologist 103TC2200X Primary

Addresses

Primary practice location

629 Fifth Ave Ste 109
Pelham, NY 10803-3708

Mailing address

629 Fifth Ave Ste 109
Pelham, NY 10803-3708
Phone (914) 368-2995

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)
Not enrolled

Practice roles

OrganizationSpecialtyStatusNew patients
Growing Minds Psychology Clinical Child & Adolescent CurrentSince Jul 2, 2023 Accepting new patients
Upshur Bren Psychology Group Clinical Child & Adolescent CurrentSince Dec 14, 2025 Accepting new patients

Locations

414 E 75th St
Fl 4
New York, NY 10021
Phone (646) 494-0790

629 Fifth Ave
Ste 109
Pelham, NY 10803
Phone (914) 222-0297

Organizations & group practices 2

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships, National Provider Directory roles and organizations whose NPPES authorized official is this provider.

NPI Registry JSON

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

{
    "created_epoch": "1687824000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1765324800000",
    "number": "1518643105",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "629 FIFTH AVE STE 109",
            "city": "PELHAM",
            "state": "NY",
            "postal_code": "108033708",
            "telephone_number": "914-368-2995"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "629 FIFTH AVE STE 109",
            "city": "PELHAM",
            "state": "NY",
            "postal_code": "108033708",
            "telephone_number": "914-368-2995"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICELI",
        "first_name": "ALESSANDRA",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2023-06-27",
        "last_updated": "2025-12-10",
        "certification_date": "2025-12-10",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "103TC2200X",
            "taxonomy_group": "",
            "desc": "Psychologist, Clinical Child & Adolescent",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Pelham, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 10, 2025; 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.