Individual provider Active NPI

Mia Estela Santiago, LCSW

  • Clinical Social Worker
  • Long Island City, NY
National Provider Identifier
1588093124
Registry record updated Apr 3, 2026
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
093183 Issued in NY
Practice address
3245 Hunters Point Ave
Long Island City, NY 11101-2524
Phone
(845) 279-5908
Fax
(845) 622-5055
NPI assigned
Nov 4, 2013
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Apr 3, 2026

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

Specialties & licenses 2

Specialty (taxonomy)CodeLicenseStatePrimary
Clinical Social Worker 1041C0700X 093183 NY Primary
Clinical Social Worker 1041C0700X 101542 NY

Addresses

Primary practice location

3245 Hunters Point Ave
Long Island City, NY 11101-2524

Mailing address

3333 Broadway Apt B12H
New York, NY 10031-8705
Phone (407) 461-5638

Other practice location 1

156 Union St
apt 1r
Brooklyn, NY 11231-5089
Phone (407) 461-5638

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NY
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
I20220527000458 NY Practitioner - Clinical Social Worker 7315325628 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
093183NYMDClinical Social Worker
101542NYMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Carmel Psychological Health, PC Clinical CurrentSince Jun 1, 2026 Accepting new patients
Shlomit Levy PastSince Apr 6, 2022 Accepting new patients

Locations

3245 Hunters Point Ave
Ste 2L
Long Island City, NY 11101
Phone (925) 231-4325

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 and National Provider Directory roles.

NPI Registry JSON

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

{
    "created_epoch": "1383523200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1775174400000",
    "number": "1588093124",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "3333 BROADWAY APT B12H",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100318705",
            "telephone_number": "407-461-5638"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "3245 HUNTERS POINT AVE",
            "city": "LONG ISLAND CITY",
            "state": "NY",
            "postal_code": "111012524",
            "telephone_number": "845-279-5908",
            "fax_number": "845-622-5055"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "156 Union St",
            "address_2": "apt 1r",
            "address_purpose": "LOCATION",
            "city": "Brooklyn",
            "state": "NY",
            "postal_code": "112315089",
            "country_code": "US",
            "telephone_number": "407-461-5638",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SANTIAGO",
        "first_name": "MIA",
        "middle_name": "ESTELA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2013-11-04",
        "last_updated": "2026-04-03",
        "certification_date": "2026-04-03",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "093183",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "101542",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Long Island City, NY

Sources for this page

Verify at the official NPI Registry.