Athina Mizero, LMSW

Primary specialty

Clinical Social WorkerTaxonomy code 1041C0700X

License

099901 Issued in NY

Practice address

13640 State Route 22
Canaan, NY 12029-3506

Phone

(518) 781-4567

NPI assigned

Jul 9, 2019

Last updated

Jul 9, 2019By the provider in NPPES

Sex

Female

Sole proprietor

No

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

Specialties & licenses 2

Addresses

Other identifiers 1

Medicare fee-for-service enrollment

Not listed in the public Medicare enrollment file

Medicare enrollment (NPD)

Not enrolled

State licenses

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

{
    "created_epoch": "1562630400000",
    "enumeration_type": "NPI-1",
    "last_updated_epoch": "1562630400000",
    "number": "1861054082",
    "addresses": [
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "MAILING",
            "address_type": "DOM",
            "address_1": "123 RYCKMAN AVE APT 3R",
            "city": "ALBANY",
            "state": "NY",
            "postal_code": "122082281",
            "telephone_number": "631-944-0817"
        },
        {
            "country_code": "US",
            "country_name": "United States",
            "address_purpose": "LOCATION",
            "address_type": "DOM",
            "address_1": "13640 STATE ROUTE 22",
            "city": "CANAAN",
            "state": "NY",
            "postal_code": "120293506",
            "telephone_number": "518-781-4567"
        }
    ],
    "practiceLocations": [],
    "basic": {
        "last_name": "MIZERO",
        "first_name": "ATHINA",
        "credential": "LMSW",
        "sole_proprietor": "NO",
        "sex": "F",
        "enumeration_date": "2019-07-09",
        "last_updated": "2019-07-09",
        "status": "A"
    },
    "taxonomies": [
        {
            "code": "101Y00000X",
            "taxonomy_group": "",
            "desc": "Counselor",
            "state": "NY",
            "license": "099901",
            "primary": false
        },
        {
            "code": "1041C0700X",
            "taxonomy_group": "",
            "desc": "Social Worker, Clinical",
            "state": "NY",
            "license": "099901",
            "primary": true
        }
    ],
    "identifiers": [
        {
            "code": "01",
            "desc": "Other (non-Medicare)",
            "issuer": "LISCENSE NUMBER",
            "identifier": "099901",
            "state": "NY"
        }
    ],
    "endpoints": [],
    "other_names": []
}

• Douglass Burns Clark, M.DIV
• Darrow School
• Paula Kaplan-Reiss
• Louise Maron, PH.D.
• Christinia Lyinn-Marie Mortimer, LPN
• Gerald E Russell III, MS, RN, NREMT, NRCMA
• Aileen Jeanelle Smith-Valley, MA
• Together for Youth
• Together for Youth

• Clinical Social Worker in Canaan, NY
• Providers in Canaan, 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 Jul 9, 2019; 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.