Individual provider Active NPI

Michelle Cusick, LCSW

  • Clinical Social Worker
  • Wilmington, NC
National Provider Identifier
1629728795
Registry record updated May 30, 2024
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
P017190 Issued in NC
Practice address
1650 Greenfield St
Wilmington, NC 28401-6456
Phone
(910) 798-3500
Fax
(910) 798-7834
NPI assigned
Mar 24, 2022
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on May 30, 2024

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 P017190 NC Primary

Addresses

Primary practice location

1650 Greenfield St
Wilmington, NC 28401-6456

Mailing address

1650 Greenfield St
Wilmington, NC 28401-6456
Phone (310) 795-4070

Other names 1

  • Michele Cusick Professional name

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Enrolled in NC
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
I20240625000559 NC Practitioner - Clinical Social Worker 9739622242 Reassigns benefits to 1 organization

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
P017190NCMDClinical Social Worker

Practice roles

OrganizationSpecialtyStatusNew patients
Soma Counseling and Wellness PLLC Current Accepting new patients
Grow Healthcare Group PA Clinical CurrentSince Apr 30, 2024 Accepting new patients

Locations

66 W Flagler St
Ste 900
Miami, FL 33130
Phone (786) 244-7711

3511 Shannon Rd
Fl 3
Durham, NC 27707
Phone (201) 293-7689

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": "1648080000000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1717027200000",
    "number": "1629728795",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1650 GREENFIELD ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016456",
            "telephone_number": "310-795-4070"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1650 GREENFIELD ST",
            "city": "WILMINGTON",
            "state": "NC",
            "postal_code": "284016456",
            "telephone_number": "910-798-3500",
            "fax_number": "910-798-7834"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "CUSICK",
        "first_name": "MICHELLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2022-03-24",
        "last_updated": "2024-05-30",
        "certification_date": "2022-04-13",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NC",
            "license": "P017190",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": [
        {
            "first_name": "MICHELE",
            "last_name": "CUSICK",
            "credential": "LCSWA",
            "code": "2",
            "type": "Professional Name"
        }
    ]
}

Other providers in Wilmington, NC

Sources for this page

Verify at the official NPI Registry.