Ida C Michie, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

SW 9793 Issued in FL

Practice address

5190 Bayou Blvd
BLDG 6
Pensacola, FL 32503-2194

Phone

(904) 476-0977

NPI assigned

May 20, 2010

Sex

Female

Sole proprietor

Yes

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

Specialties & licenses 2

Addresses

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Enrolled

State licenses

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

{
    "created_epoch": "1274313600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1274313600000",
    "number": "1710206404",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "5190 BAYOU BLVD",
            "address_2": "BLDG 6",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032194",
            "telephone_number": "904-476-0977"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "5190 BAYOU BLVD",
            "address_2": "BLDG 6",
            "city": "PENSACOLA",
            "state": "FL",
            "postal_code": "325032194",
            "telephone_number": "904-476-0977"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MICHIE",
        "first_name": "IDA",
        "middle_name": "C",
        "name_prefix": "Dr.",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2010-05-20",
        "last_updated": "2010-05-20",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "FL",
            "license": "SW 9793",
            "primary": true
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "WY",
            "license": "SW 347",
            "primary": false
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Susan Michaels, ARNP, PMHNP
• Cheyanne Michaelson
• Audrey E Michal, MD
• Patricia Michel-Garrison, D.O.
• Habakuk Michel, MD
• Michigan Ams PLLC
• Casey Mickler, M.D.
• Mid-South Home Care Services, Inc.
• Mid-South Palliative Services, LLC
• Christopher Michael Middendorf, D.O.

• Clinical Social Worker in Pensacola, FL
• Providers in Pensacola, FL by specialty
• Clinical Social Worker in Florida

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on May 20, 2010; 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.