Individual provider Active NPI

Michelle Siegel, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
National Provider Identifier
1770123754
Registry record updated Mar 1, 2021
On this page

Key facts

NPPES NPI Registry
Primary specialty
Clinical Social WorkerTaxonomy code 1041C0700X
License
099496 Issued in NY
Practice address
1268 E 14TH St
Brooklyn, NY 11230-5241
Phone
(718) 382-0045
Fax
(718) 382-0051
NPI assigned
Jan 8, 2020
Sex
Female
Sole proprietor
No

NPPES NPI Registry

Updated by the provider on Mar 1, 2021

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 099496 NY Primary

Addresses

Primary practice location

1268 E 14TH St
Brooklyn, NY 11230-5241

Mailing address

1268 E 14TH St
Brooklyn, NY 11230-5241
Phone (718) 382-0045

Other practice location 1

1225 Gerard Ave
Bronx, NY 10452-8015
Phone (718) 960-2857

Medicare participation

Medicare enrollment files
Medicare fee-for-service enrollment
Not listed in the public Medicare enrollment file
Eligible to order & refer
  • Part B services: No
  • Medical equipment: Yes
  • Home health: No
  • Power mobility devices: No
  • Hospice: No
Green means eligible to order or refer.

National Provider Directory

National Provider Directory
Medicare enrollment (NPD)
Enrolled

State licenses

LicenseStateTypeSpecialty
099496NYMDClinical Social Worker

NPI Registry JSON

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

{
    "created_epoch": "1578441600000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1614556800000",
    "number": "1770123754",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "1268 E 14TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305241",
            "telephone_number": "718-382-0045",
            "fax_number": "718-382-0051"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1268 E 14TH ST",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112305241",
            "telephone_number": "718-382-0045",
            "fax_number": "718-382-0051"
        }
    ],
    "practiceLocations": [
        {
            "address_1": "1225 Gerard Ave",
            "address_purpose": "LOCATION",
            "city": "Bronx",
            "state": "NY",
            "postal_code": "104528015",
            "country_code": "US",
            "telephone_number": "718-960-2857",
            "country_name": "United States",
            "address_type": "DOM"
        }
    ],
    "basic": {
        "last_name": "SIEGEL",
        "first_name": "MICHELLE",
        "credential": "LCSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2020-01-08",
        "last_updated": "2021-03-01",
        "certification_date": "2021-03-01",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "099496",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

Other providers in Brooklyn, NY

Sources for this page

Verify at the official NPI Registry.