Mike Izzo Therapy LLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

Legal business name

MIKE IZZO THERAPY LLC

Practice address

121 Cushing Ave
Dorchester, MA 02125-2031

Phone

(931) 551-5802

NPI assigned

Feb 10, 2025

Organization subpart

No

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

Authorized official

Name

Michael C Izzo, LICSWNPI 1174244222

Title

Owner / Practicioner

Phone

(931) 551-5802

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.

• Michael Carmine Izzo, LCSW

  • Clinical Social Worker
  • Boston, MA
  • NPI 1174244222
  NPD Authorized official

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

{
    "created_epoch": "1739145600000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1739145600000",
    "number": "1730994658",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "121 CUSHING AVE",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021252031",
            "telephone_number": "931-551-5802"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "121 CUSHING AVE",
            "city": "DORCHESTER",
            "state": "MA",
            "postal_code": "021252031",
            "telephone_number": "931-551-5802"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MIKE IZZO THERAPY LLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2025-02-10",
        "last_updated": "2025-02-10",
        "certification_date": "2025-02-07",
        "status": "A",
        "authorized_official_last_name": "IZZO",
        "authorized_official_first_name": "MICHAEL",
        "authorized_official_middle_name": "C",
        "authorized_official_title_or_position": "OWNER / PRACTICIONER",
        "authorized_official_telephone_number": "931-551-5802",
        "authorized_official_credential": "LICSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": null,
            "license": null,
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Dorchester, MA
• Providers in Dorchester, MA by specialty
• Clinical Social Worker in Massachusetts

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Feb 10, 2025; 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.