Active NPI
Michelle Eubanks-Reshard, LCSW
- Clinical Social Worker
- Elmont, NY
National Provider Identifier
1588093702
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Clinical Social Worker
- License
- 070874-1
- Practice address
- 89 Queens Ave
Elmont, NY 11003-4338 - Phone
- (516) 984-3564
- NPI assigned
- Nov 7, 2013
- Sex
- Female
- Sole proprietor
- Yes
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Clinical Social Worker | 1041C0700X | 070874-1 | NY | Primary |
Addresses
Primary practice location
89 Queens Ave
Elmont, NY 11003-4338
Mailing address
360A West Merrick Rd,Ste 209
Valley Stream, NY 11580
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
| License | State | Type | Specialty |
|---|---|---|---|
| 070874-1 | NY | MD | Clinical Social Worker |
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1383782400000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1392854400000",
"number": "1588093702",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "360A WEST MERRICK RD,STE 209",
"city": "VALLEY STREAM",
"state": "NY",
"postal_code": "11580"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "89 QUEENS AVE",
"city": "ELMONT",
"state": "NY",
"postal_code": "110034338",
"telephone_number": "516-984-3564"
}
],
"practiceLocations": [],
"basic": {
"last_name": "EUBANKS-RESHARD",
"first_name": "MICHELLE",
"credential": "LCSW",
"sole_proprietor": "YES",
"sex": "F",
"enumeration_date": "2013-11-07",
"last_updated": "2014-02-20",
"status": "A"
},
"taxonomies": [
{
"code": "1041C0700X",
"taxonomy_group": "",
"desc": "Social Worker, Clinical",
"state": "NY",
"license": "070874-1",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Elmont, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 20, 2014; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
- National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.