Individual provider Active NPI

Michael Simon, LSW

  • Clinical Social Worker
  • Princeton, NJ
National Provider Identifier
1578156352
Registry record updated Feb 12, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
44SL06506000 Issued in NJ
Practice address
245C Nassau St
Princeton, NJ 08540-4619
Phone
(609) 375-8727
Fax
(609) 526-8511
NPI assigned
Feb 12, 2021
Last updated
Feb 12, 2021By the provider in NPPES
Sex
Male
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Feb 12, 2021

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 44SL06506000 NJ Primary

Addresses

Primary practice location

245C Nassau St
Princeton, NJ 08540-4619

Mailing address

52 Spruce St
Princeton, NJ 08542-3812
Phone (917) 595-6063

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NJ
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

Enrollment IDStateProvider typePAC IDDetails
I20230510000090 NJ Practitioner - Clinical Social Worker 6204292626 Reassigns benefits to 1 organization

Care Compare profile

Medicare Care Compare
Specialty
Clinical Social Worker
Education
Rutgers New Jersey Medical School, 2019
Medicare assignment
Accepts the Medicare-approved amount as payment in full
Telehealth
Offers telehealth services
Group practices
TLP Consulting Group LLCGroup PAC ID 4789007089, 4 clinicians

Practice addresses (Care Compare)

245 C Nassau St
Princeton Ctr for Mindbody Healing
Princeton, NJ 08540-4619
Phone (609) 375-8727

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
44SL06506000NJMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
TLP Consulting Group LLC Clinical CurrentSince Apr 26, 2023 Accepting new patients

Locations

245 Nassau St
#C
Princeton, NJ 08540
Phone (609) 375-8727

Organizations & group practices 1

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": "1613088000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1613088000000",
    "number": "1578156352",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "52 SPRUCE ST",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085423812",
            "telephone_number": "917-595-6063"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "245C NASSAU ST",
            "city": "PRINCETON",
            "state": "NJ",
            "postal_code": "085404619",
            "telephone_number": "609-375-8727",
            "fax_number": "609-526-8511"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "SIMON",
        "first_name": "MICHAEL",
        "credential": "LSW",
        "sole_proprietor": "NO",
        "sex": "M",
        "enumeration_date": "2021-02-12",
        "last_updated": "2021-02-12",
        "certification_date": "2021-02-12",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NJ",
            "license": "44SL06506000",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Princeton, NJ

Sources for this page

Verify at the official NPI Registry.