Dynamic Psychotherapy LCSW PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

DYNAMIC PSYCHOTHERAPY LCSW PLLC

Practice address

220 5TH Ave FL 11
New York, NY 10001-8017

Phone

(609) 273-1391

NPI assigned

Jun 21, 2023

Last updated

Jun 21, 2023By the provider in NPPES

Organization subpart

No

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

Authorized official

Name

Alessandra Mikic, LCSWNPI 1023587573

Title

Owner

Phone

(609) 273-1391

Specialties & licenses 1

Addresses

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles, and the practitioner matching its NPPES authorized official.

• Alessandra Mikic, LCSW

  • Clinical Social Worker
  • New York, NY
  • NPI 1023587573
  Authorized official Same address or phone

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

{
    "created_epoch": "1687305600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1687305600000",
    "number": "1700561198",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "220 5TH AVE FL 11",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100018017"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "220 5TH AVE FL 11",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100018017",
            "telephone_number": "609-273-1391"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "315 W 115th St Apt 54",
            "address_purpose": "LOCATION",
            "city": "New York",
            "state": "NY",
            "postal_code": "100262307",
            "country_code": "US",
            "telephone_number": "609-273-1391",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "organization_name": "DYNAMIC PSYCHOTHERAPY LCSW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2023-06-21",
        "last_updated": "2023-06-21",
        "certification_date": "2023-06-21",
        "status": "A",
        "authorized_official_last_name": "MIKIC",
        "authorized_official_first_name": "ALESSANDRA",
        "authorized_official_title_or_position": "OWNER",
        "authorized_official_telephone_number": "609-273-1391",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NU",
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in New York, NY
• Providers in New York, 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 Jun 21, 2023; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.