Active NPI
Thomas Michael Nuckel, LMSW
- Social Worker
- Valley Stream, NY
National Provider Identifier
1871144428
On this page
Key facts
NPPES NPI Registry- Primary specialty
- Social Worker
- License
- 105615
- Practice address
- 50 W Hawthorne Ave FL 2
Valley Stream, NY 11580-6220 - Phone
- (516) 569-6600
- NPI assigned
- Sep 25, 2019
- Sex
- Male
- Sole proprietor
- No
NPPES NPI Registry
Registry information is reported by the provider to CMS and is not verified. About this source
Specialties & licenses 1
| Specialty (taxonomy) | Code | License | State | Primary |
|---|---|---|---|---|
| Social Worker | 104100000X | 105615 | NY | Primary |
Addresses
Primary practice location
50 W Hawthorne Ave FL 2
Valley Stream, NY 11580-6220
Mailing address
822 E Park Ave
Long Beach, NY 11561-2701
Medicare participation
Medicare enrollment files- Medicare fee-for-service enrollment
- Not listed in the public Medicare enrollment file
National Provider Directory
National Provider Directory- Medicare enrollment (NPD)
- Not enrolled
State licenses
| License | State | Type | Specialty |
|---|---|---|---|
| 105615 | NY | MD | Social Worker |
Practice roles
| Organization | Specialty | Status | New patients |
|---|---|---|---|
| Jason Diana LCSW | Past | Accepting new patients |
Organizations & group practices 1
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.
-
- Clinical Social Worker
- Brookville, NY
- NPI 1942807276
NPI Registry JSON
The complete NPPES record for this NPI in the NPI Registry API format.
{
"created_epoch": "1569369600000",
"enumeration_type": "NPI-1",
"last_updated_epoch": "1569369600000",
"number": "1871144428",
"addresses": [
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "MAILING",
"address_type": "DOM",
"address_1": "822 E PARK AVE",
"city": "LONG BEACH",
"state": "NY",
"postal_code": "115612701"
},
{
"country_code": "US",
"country_name": "United States",
"address_purpose": "LOCATION",
"address_type": "DOM",
"address_1": "50 W HAWTHORNE AVE FL 2",
"city": "VALLEY STREAM",
"state": "NY",
"postal_code": "115806220",
"telephone_number": "516-569-6600"
}
],
"practiceLocations": [],
"basic": {
"last_name": "NUCKEL",
"first_name": "THOMAS",
"middle_name": "MICHAEL",
"name_prefix": "Mr.",
"credential": "LMSW",
"sole_proprietor": "NO",
"sex": "M",
"enumeration_date": "2019-09-25",
"last_updated": "2019-09-25",
"status": "A"
},
"taxonomies": [
{
"code": "104100000X",
"taxonomy_group": "",
"desc": "Social Worker",
"state": "NY",
"license": "105615",
"primary": true
}
],
"identifiers": [],
"endpoints": [],
"other_names": []
}Other providers in Valley Stream, NY
Sources for this page
- NPPES NPI Registry (CMS): identity, addresses, specialties, licenses, identifiers and endpoints. Last updated by the provider on Sep 25, 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.