Individual provider Active NPI

Michelle Lynn Seufert, LMSW

  • Clinical Social Worker
  • Miller Place, NY
National Provider Identifier
1568093185
Registry record updated Dec 18, 2020
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
090324 Issued in NY
Practice address
565 Route 25a
Miller Place, NY 11764-2663
Phone
(631) 219-4292
NPI assigned
Feb 2, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Dec 18, 2020

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Social Worker 104100000X 096871 NY
Clinical Social Worker 1041C0700X 090324 NY Primary

Addresses

Primary practice location

565 Route 25a
Miller Place, NY 11764-2663

Mailing address

86 Enfield CT Unit D
Ridge, NY 11961-1466
Phone (631) 219-4292

Other practice location 1

1490 William Floyd Pkwy Ste 106
Shirley, NY 11967-1820
Phone (631) 336-9990

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

State licenses

LicenseStateTypeSpecialty
090324NYMDClinical Social Worker
096871NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1580601600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1608249600000",
    "number": "1568093185",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "86 ENFIELD CT UNIT D",
            "city": "RIDGE",
            "state": "NY",
            "postal_code": "119611466",
            "telephone_number": "631-219-4292"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "565 ROUTE 25A",
            "city": "MILLER PLACE",
            "state": "NY",
            "postal_code": "117642663",
            "telephone_number": "631-219-4292"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1490 William Floyd Pkwy Ste 106",
            "address_purpose": "LOCATION",
            "city": "Shirley",
            "state": "NY",
            "postal_code": "119671820",
            "country_code": "US",
            "telephone_number": "631-336-9990",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SEUFERT",
        "first_name": "MICHELLE",
        "middle_name": "LYNN",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-02-02",
        "last_updated": "2020-12-18",
        "certification_date": "2020-12-18",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "104100000X",
            "taxonomy_group": "",
            "desc": "Social Worker",
            "state": "NY",
            "license": "096871",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "090324",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Miller Place, NY

Sources for this page

  • NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 18, 2020; 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.