Mdesimone Psychotherapy Services LCSW PLLC

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

078873 Issued in NY

Legal business name

MDESIMONE PSYCHOTHERAPY SERVICES LCSW PLLC

Practice address

300 Cadman PLZ W # 12
1 Pierrepont Plaza
Brooklyn, NY 11201-2701

Phone

(917) 364-9983

Fax

(212) 594-1213

NPI assigned

Dec 14, 2015

Organization subpart

No

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

Authorized official

Name

Michelle Desimone, LCSWNPI 1801038278

Title

LCSW

Phone

(917) 364-9983

Specialties & licenses 1

Addresses

Medicare fee-for-service enrollment

Enrolled in NY

Enrollment records 1

Practitioners 1

Individual providers connected to this organization through Medicare benefit reassignment, Care Compare group membership or National Provider Directory roles.

• Michelle Angelee Desimone, LCSW

  • Clinical Social Worker
  • Brooklyn, NY
  • NPI 1801038278
  Medicare reassignment Authorized official

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

{
    "created_epoch": "1450051200000",
    "enumeration_type": "NPI-2",
    "last_updated_epoch": "1456272000000",
    "number": "1801261094",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "300 CADMAN PLZ W # 12",
            "address_2": "1 PIERREPONT PLAZA",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112012701",
            "telephone_number": "917-364-9983",
            "fax_number": "212-594-1213"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "300 CADMAN PLZ W # 12",
            "address_2": "1 PIERREPONT PLAZA",
            "city": "BROOKLYN",
            "state": "NY",
            "postal_code": "112012701",
            "telephone_number": "917-364-9983",
            "fax_number": "212-594-1213"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "organization_name": "MDESIMONE PSYCHOTHERAPY SERVICES LCSW PLLC",
        "organizational_subpart": "NO",
        "enumeration_date": "2015-12-14",
        "last_updated": "2016-02-24",
        "status": "A",
        "authorized_official_last_name": "DESIMONE",
        "authorized_official_first_name": "MICHELLE",
        "authorized_official_title_or_position": "LCSW",
        "authorized_official_telephone_number": "917-364-9983",
        "authorized_official_credential": "LCSW"
    },
    "taxonomies": [
        {
            "code": "1041C0700X",
            "taxonomy_group": "193400000X SINGLE SPECIALTY  GROUP",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "078873",
            "primary": true
        }
    ],
    "identifiers": [],
    "endpoints": [],
    "other_names": []
}

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• Clinical Social Worker in Brooklyn, NY
• Providers in Brooklyn, 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 Feb 24, 2016; self-reported and not verified by CMS. Specialty names from the NUCC taxonomy.
• Medicare enrollment (CMS PECOS): enrollments, PAC IDs and benefit reassignments.
• National Provider Directory (CMS): practice roles, locations, licenses, networks and endpoints.

Verify at the official NPI Registry.