Nicole Memoli, LCSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

079183 Issued in NY

Practice address

160 W End Ave
1N
New York, NY 10023-5601

Phone

(646) 644-9480

NPI assigned

Sep 24, 2012

Last updated

Sep 24, 2012By the provider in NPPES

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 NY

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

Specialty

Clinical Social Worker

Education

Other, 1995

Medicare assignment

Accepts the Medicare-approved amount as payment in full

Group practices

My Therapist LCSW PLLCGroup PAC ID 9335473818, 2 clinicians

Practice addresses (Care Compare)

Medicare enrollment (NPD)

Enrolled

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

• My Therapist LCSW, PLLC

  • Community/Behavioral Health Agency
  • Bronx, NY
  • NPI 1164624151
  Medicare reassignment Care Compare group

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

{
    "created_epoch": "1348444800000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1348444800000",
    "number": "1801147483",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "111 GRAND ST STE 3",
            "city": "CROTON ON HUDSON",
            "state": "NY",
            "postal_code": "105202371",
            "telephone_number": "646-644-9480"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "160 W END AVE",
            "address_2": "1N",
            "city": "NEW YORK",
            "state": "NY",
            "postal_code": "100235601",
            "telephone_number": "646-644-9480"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MEMOLI",
        "first_name": "NICOLE",
        "credential": "LCSW",
        "sole_proprietor": "YES",
        "sex": "F",
        "enumeration_date": "2012-09-24",
        "last_updated": "2012-09-24",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "079183",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

• Maia Membreno
• Jessica Meme, LMSW
• Alaima Memminger
• Jessica Lynn Memoli, LCSW
• Kristin Memoli, RDH
• Amaar Memon
• Sehrish Memon, M.D
• Shazia Memon, FNP-BC
• Memorial Anesthesiology Group
• Memorial Cardiopulmonary Group

• 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 Sep 24, 2012; 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.
• Medicare Care Compare (CMS): clinician profile, group practices, facility affiliations, MIPS scores and star ratings.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.