Stephan P Michener, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

R033475-1 Issued in NY

Practice address

6780 Pittsford Palmyra Rd
Fairport, NY 14450-3360

Phone

(585) 383-4478

Fax

(585) 383-4478

NPI assigned

Nov 21, 2006

Sex

Male

Sole proprietor

Yes

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

Specialties & licenses 1

Addresses

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

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1164067200000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1183939200000",
    "number": "1699840009",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "6780 PITTSFORD PALMYRA RD",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144503360",
            "telephone_number": "585-383-4478",
            "fax_number": "585-383-4478"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "6780 PITTSFORD PALMYRA RD",
            "city": "FAIRPORT",
            "state": "NY",
            "postal_code": "144503360",
            "telephone_number": "585-383-4478",
            "fax_number": "585-383-4478"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHENER",
        "first_name": "STEPHAN",
        "middle_name": "P",
        "name_prefix": "Mr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "M",
        "enumeration_date": "2006-11-21",
        "last_updated": "2007-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "R033475-1",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Leslie Stephen Mentel, L.AC.
• Theresa Adele Meyers, LMSW
• Kimberlee Hooey Miale, M.A., CCC-SLP
• Stacy Ann Michaels
• Ernesto Michelucci, PH.D.
• Richard A Micoli, D.D.S.
• Amy Virginia Mikels, M.S.
• Richard W Millard, PH.D.
• Catherine Ann Miller, M.D.
• Jennifer W Miller, CCC/SLP

• Clinical Social Worker in Fairport, NY
• Providers in Fairport, 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 9, 2007; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments; Order and Referring.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.