Michelle Beth Iankowitz

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

93348 Issued in CA

Practice address

1000 Quail St Ste 175
Newport Beach, CA 92660-2766

Phone

(310) 595-8362

NPI assigned

Dec 11, 2019

Sex

Female

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 CA

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

Practice roles

Locations

Organizations this provider is connected to: Medicare benefit reassignments (the organization bills Medicare for this provider’s services), Care Compare group memberships and National Provider Directory roles.

• Forward Wellness Family Therapy, Inc.

  • Community/Behavioral Health Agency
  • Placentia, CA
  • NPI 1093398059
  Medicare reassignment NPD

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

{
    "created_epoch": "1576022400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1576022400000",
    "number": "1790323640",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "17200 NEWHOPE ST APT 32A",
            "city": "FOUNTAIN VALLEY",
            "state": "CA",
            "postal_code": "927084248",
            "telephone_number": "310-595-8362"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "1000 QUAIL ST STE 175",
            "city": "NEWPORT BEACH",
            "state": "CA",
            "postal_code": "926602766",
            "telephone_number": "310-595-8362"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "IANKOWITZ",
        "first_name": "MICHELLE",
        "middle_name": "BETH",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2019-12-11",
        "last_updated": "2019-12-11",
        "certification_date": "2019-12-11",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "CA",
            "license": "93348",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Shannon Patricia Hybl, LMFT
• I2B Lab LLC
• Angela Cerice Iacovino, D.C.
• Ian Dworkin, M.D. Inc.
• Alexandra Georgiana Ianculescu, M.D., PH.D.
• John Mina Ibrahim, MD
• Diane Ilan, M.F.T.
• Hayley Janelle Immel
• In Home Care Solutions
• Carey Sherilyn Incledon

• Clinical Social Worker in Newport Beach, CA
• Providers in Newport Beach, CA by specialty
• Clinical Social Worker in California

• NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Dec 11, 2019; 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.