Mary A Miceli, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R051448 Issued in NY

Practice address

174 3Rd Street
Staten Island, NY 10306-2210

Phone

(718) 668-2945

Fax

(718) 668-2945

NPI assigned

Jan 23, 2007

Last updated

Jul 8, 2007By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 1

Addresses

Other identifiers 2

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1169510400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183852800000",
    "number": "1578617916",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "174 3RD STREET",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062210",
            "telephone_number": "718-668-2945",
            "fax_number": "718-668-2945"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "174 3RD STREET",
            "city": "STATEN ISLAND",
            "state": "NY",
            "postal_code": "103062210",
            "telephone_number": "718-668-2945",
            "fax_number": "718-668-2945"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICELI",
        "first_name": "MARY",
        "middle_name": "A",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2007-01-23",
        "last_updated": "2007-07-08",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R051448",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "AETNA",
            "identifier": "7700310",
            "state": null
        },
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "OXFORD",
            "identifier": "P2409429",
            "state": null
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Brooke Miano, OTR/L
• Lindsay Miarmi, PH.D.
• Rachel Mica, RN
• Tonianne Marie Micara, MS ED
• Jack Miceli, DDS
• Peter Joseph Miceli, M.D.
• Michael B. Kushner DDS PC (Forest Dental)
• Michael Castania (Elite Mobility & Physical Therapy)
• Michael Costes, MD
• Michael Joseph Tadros MD PLLC

• Clinical Social Worker in Staten Island, NY
• Providers in Staten Island, NY by specialty
• Clinical Social Worker in New York

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Jul 8, 2007; 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.