Michael James Polichetti, MSW, LISW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

I.2002052-SUPV Issued in OH

Practice address

165 E Park Ave
Niles, OH 44446-2352

Phone

(330) 544-8005

Fax

(330) 544-9379

NPI assigned

Jun 6, 2017

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Enrolled in OH

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

Practice roles

Locations

Interoperability endpoints

• FHIR API: https://fhir.nextgen.com/nge/prod/fhir-api-r4/fhir/r4/

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.

• Cadence Care Network

  • Adolescent and Children Mental Health Clinic/Center
  • Niles, OH
  • NPI 1558339762
  Medicare reassignment NPD
• Cadence Care Network

  • Substance Use Disorder Rehabilitation Clinic/Center
  • Niles, OH
  • NPI 1053928416
  NPD

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

{
    "created_epoch": "1496707200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717545600000",
    "number": "1578092359",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "230 HERITAGE LN",
            "city": "CORTLAND",
            "state": "OH",
            "postal_code": "444101118",
            "telephone_number": "716-672-9411"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "165 E PARK AVE",
            "city": "NILES",
            "state": "OH",
            "postal_code": "444462352",
            "telephone_number": "330-544-8005",
            "fax_number": "330-544-9379"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "POLICHETTI",
        "first_name": "MICHAEL",
        "middle_name": "JAMES",
        "name_prefix": "Mr.",
        "credential": "MSW, LISW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2017-06-06",
        "last_updated": "2024-06-05",
        "certification_date": "2024-06-05",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "OH",
            "license": "I.2002052-SUPV",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "05",
            "desc": "MEDICAID",
            "issuer": null,
            "identifier": "0278508",
            "state": "OH"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Lauren Christine Plant, LSW
• April Rose Platt
• Cassandra Pleacher
• Eugene D Podolsky, DPM
• Elizabeth Pojman
• Joseph A Potocki, DO
• Amanda Praytor
• Premium Pediatrics
• Deanna Prezioso
• Daren Price Jr

• Clinical Social Worker in Niles, OH
• Providers in Niles, OH by specialty
• Clinical Social Worker in Ohio

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jun 5, 2024; 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.