Individual provider Active NPI

Ana Muller-Spina, LCSW

  • Clinical Social Worker
  • Melville, NY
National Provider Identifier
1669551073
Registry record updated Sep 11, 2023
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
069519 Issued in NY
Practice address
200 Broadhollow Rd Ste 206
Melville, NY 11747-4806
Phone
(516) 695-6880
Fax
(631) 509-5105
NPI assigned
Nov 4, 2006
Sex
Female
Sole proprietor
Yes

NPPES NPI Registry

Updated by the provider on Sep 11, 2023

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 069519 NY Primary

Addresses

Primary practice location

200 Broadhollow Rd Ste 206
Melville, NY 11747-4806

Mailing address

200 Broadhollow Rd Ste 207
Melville, NY 11747-4806
Phone (516) 695-6880

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
I20140729000583 NY Practitioner - Clinical Social Worker 2062638067 Practice locations: Port Jefferson, NY

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
069519NYMDPharmacist

Networks

  • Healthfirst Medicare Network H1722
  • Healthfirst Medicare Network H5989
  • Healthfirst Medicare Network H9678
  • Healthfirst Medicare Network H3359

NPI Registry JSON

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

{
    "created_epoch": "1162598400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1694390400000",
    "number": "1669551073",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "200 BROADHOLLOW RD STE 207",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474806",
            "telephone_number": "516-695-6880",
            "fax_number": "984-242-4254"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "200 BROADHOLLOW RD STE 206",
            "city": "MELVILLE",
            "state": "NY",
            "postal_code": "117474806",
            "telephone_number": "516-695-6880",
            "fax_number": "631-509-5105"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MULLER-SPINA",
        "first_name": "ANA",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2006-11-04",
        "last_updated": "2023-09-11",
        "certification_date": "2023-09-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "069519",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Melville, NY

Sources for this page

Verify at the official NPI Registry.